New York's highest court of appeals has held that no-fault insurers cannot deny no-fault benefits where they unilaterally determine that a provider has committed misconduct based upon alleged fraudulent conduct. The Court held that this authority belongs solely to state regulators, specifically New York's Board of Regents, which oversees professional licensing and discipline. This follows a similar recent ruling in Florida reported in this publication.
I.Q. -- Interesting Quote
HMO Gorilla Poised to Dominate Market
The following quote from the American Medical News is further proof that HMOs are not only a reality for the chiropractic profession, but that they will become more and more prevalent in the future:
"If managed care was the health care industry's 800-pound gorilla in 1995, it's poised to dominate markets like King Kong during 1996.""HMOs dominate, shape the market," American Medical News, January 22/29, 1996."HMO enrollment is projected to near 65 million Americans this year -- up more than 25% from the 50 million members in health plans last January, according to a leading Wall Street analyst."