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Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Ambulatory Payment Classification for hospital outpatient claims Current Procedural Terminology for other outpatient claims The PPS was established by the Centers for Medicare and Medicaid Services (CMS), as a result of the Social Security Amendments Act of 1983 , specifically to address expensive hospital care.
The bundling of Microsoft Windows is the installation of Microsoft Windows in computers before their purchase. Microsoft encourages original equipment manufacturers (OEMs) of personal computers to include Windows licenses with their products, and agreements between Microsoft and OEMs have undergone antitrust scrutiny.
Unlike capitation, bundled payment does not penalize providers for caring for sicker patients. [ 5 ] Considering the advantages and disadvantages of fee-for-service, pay for performance , bundled payment for episodes of care, and global payment such as capitation, Mechanic and Altman concluded that "episode payments are the most immediately ...
The jury returned a verdict for LePage's on the monopolization claim under § 2 of the Sherman Act, and assessed damages of $23 million. The jury found in 3M's favor on LePage's claims under § 1 of the Sherman Act and § 3 of the Clayton Act. [4] Cross-appeals to the Third Circuit followed, and the court heard the case en banc.
Bundling is the setting of the total price of a purchase of several products or services from one seller at a lower level than the sum of the prices of the products or services purchased separately from several sellers.
Under the new rules, if the claims as filed in a European patent application contain a plurality of independent claims in the same claim category and if the EPO considers in that case that the claims therefore do not comply with Rule 43(2) EPC, the EPO may "invite the applicant to indicate, within a period of two months, the claims complying ...
The lawsuits claim that, due to Sanofi's prominence in the vaccine market, the contracts make it virtually impossible for competitors to gain any market share. Sanofi responded that there are alternatives to all of the vaccines in the bundle, and that Novartis already has 20 percent of the market share for its competing vaccine.