Rules of Medical Necessity

Health insurance has long been understood to cover most forms of “medically necessary” health care. But who gets to decide whether particular medical interventions for individual patients are indeed “medically necessary” and hence covered? In his talk, Professor Schwarcz will argue that health insurers are increasingly avoiding legal and regulatory constraints on their medical necessity determinations by altering their insurance policies to include detailed rules for what types of care they deem to be medically necessary.

This CLE is approved for credit through April 27, 2024.