Document Type
Article
Publication Date
10-2008
Journal Title
Indiana Health Law Review
ISSN
1549-3199
DOI
10.18060/16519
Abstract
In our judgment, Hoffmann and Rowthorn's research clearly demonstrates that the QIO-based complaint review process does not provide genuine relief to beneficiaries. People who complain typically want an explanation of their bad experience, compensation for harm they may have suffered, and assurance that future experiences will be better for themselves and for others. Medicare beneficiaries, however, receive minimal information about the resolution of their complaints and no substantive relief whatsoever.
As Hoffmann and Rowthorn point out, several reform proposals are now before Congress, including moving the beneficiary complaint function from QIOs to new "Medicare Provider Review Organizations." It is not clear from the authors' analysis what is motivating bipartisan interest in reform, but it seems to involve potentially conflicting concerns about lack of consumer responsiveness, on one hand, and wasteful bureaucracy, on the other.
First Page
1
Last Page
7
Num Pages
7
Volume Number
5
Issue Number
1
Publisher
Indiana University School of Law - Indianapolis
Recommended Citation
Eleanor D. Kinney & William M. Sage,
Dances With Elephants: Administrative Resolution of Medical Injury Claims by Medicare Beneficiaries,
5
Ind. Health L. Rev.
1
(2008).
Available at:
https://scholarship.law.tamu.edu/facscholar/1708
File Type
Included in
Health Law and Policy Commons, Insurance Law Commons, Medical Jurisprudence Commons, Torts Commons