医疗保险对“合理且必要”医疗的不懈定义之争。
Medicare's enduring struggle to define "reasonable and necessary" care.
机构信息
Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, USA.
出版信息
N Engl J Med. 2012 Nov 8;367(19):1775-7. doi: 10.1056/NEJMp1208386. Epub 2012 Oct 31.
PMID:23113832
Abstract
Medicare legislation mandates that the program not pay for items and services that are not "reasonable and necessary" - terms that are open to interpretation and easily politicized. In today's fiscal environment, "reasonable and necessary" warrants a closer look.
摘要
医疗保险立法规定，该计划不支付“合理和必要”的项目和服务-这些术语可进行解释，并且很容易被政治化。在当前的财政环境下，“合理和必要”值得仔细研究。
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