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| | Research for Medical Necessity Legislation (Site not responding. Last check: 2007-11-07) |
 | | In the 1970s, before the advent of managed care, the term medical necessity came into use in insurance contracts in order to exclude care, such as voluntary hospitalization and surgery, that was prescribed primarily for the convenience of the provider or the patient. |
 | | Because the medical necessity debate is usually over the discretion to construe or interpret contract terms, there is very little discussion about the meaning of medical necessity, or appropriate criteria for its determination. |
 | | This legislation would define "medically necessary care" and "medical necessity" in statute according to criteria that is reasonable, global, patient-based, duly deferential to the judgment of the treating physician, and most of all, fair. |
| www.healthlobby.com /billrpt.htm (3534 words) |
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