Policy Commercial Members: Managed Care (HMO and POS), PPO, and Indemnity Medicare HMO Blue and Medicare PPO Blue Members Genetic tests for the screening, detection, and management of prostate cancer are INVESTIGATIONAL. This includes, but is not limited to the following:  Single-nucleotide polymorphisms (SNPs) for risk assessment, or  PCA3 for disease diagnosis and prognosis, or  TMPRSS fus...

Data in table 1 give the actual or estimated number of persons covered at the end of 1965 for hospital care, surgical service, and physician inhospital visits by the Blue Cross and Blue Shield plans, by insurance companies, and by the independent plans. “Covered” means having some health insurance protection against the cost of these services. Benefits may be in the form of entitlement to servi...

This note provides two results pertaining to the pricing of agricultural revenue insurance contracts under joint price and yield risk. First, a weakening of the concordance ordering is used to sign the effect of greater dependence between the multiplicative risks (price and yield) on the expected indemnity payment. Second, sufficient conditions are found when the premium rate for revenue insura...

We examine the management of livestock diseases from the producers’ perspective, incorporating information and incentive asymmetries between producers and regulators. Using a dynamic model, we examine responses to different policy options including indemnity payments, subsidies to report at-risk animals, monitoring, and regulatory approaches to decreasing infection risks when perverse incentive...

Commercial aviation in-flight emergencies are relatively common, so it is likely that a doctor travelling frequently by air will receive a call for help at some stage in their career. These events are stressful, even for experienced physicians. The present paper reviews what is known about the incidence and types of in-flight emergencies that are likely to be encountered, the international regu...

BACKGROUND The independent oversight of clinical trials, which is recommended by the Medical Research Council (MRC) Guidelines for Good Clinical Practice, is typically provided by an independent advisory Data Monitoring Committee (DMC) and an independent executive committee, to whom the DMC makes recommendations. The detailed roles and function of this executive committee, known as the Trial St...

This study examines how wellness scores generated from the Health Risk Appraisal are associated with prospective medical claims costs, controlling for age, gender, and disease status. The study was conducted among 19,861 active employees who participated in the Health Risk Appraisal and selected indemnity or PPO medical plans from 1996 to 1998. A multiple regression model based on group average...

Medical negligence has been the subject of much public debate in recent decades. Although the steep increase in the frequency and size of claims against doctors at the end of the last century appears to have plateaued, in Australia at least, medical indemnity costs and consequences are still a matter of concern for doctors, medical defence organisations and governments in most developed countri...

Informed consent (IC), a fundamental principle of ethics in medical research, is recognized as a vital component of HIV vaccine trials. There are different notions of IC, some legally based and others based on ethics. It is argued that, though legal indemnity is necessary, vaccine trials should be founded on fully ethical considerations. Various contentious aspects of IC are examined, especiall...