Word: contraction
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Dates: during 1990-1999
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...Hunter became a patient of Dr. Adrian Rubin, who agreed with the Greenville doctor that Hunter needed a new liver but who also recognized that insurance was very much a factor. Rubin consulted with the hospital's financial staff, which confirmed that MUSC did not have a liver-transplant contract with Hunter's carrier, Physician's Health Plan. But, Rubin was told, Duke, where he knew the liver people, did have a PHP contract. So the physician recommended that Hunter go there. Rubin placed a call to Duke hepatologist James Trotter, explaining that he had a seriously ill transplant candidate...
...operation that could cost anywhere from $80,000, if the procedure went smoothly, to perhaps $1 million, if complications arose. The precipitating error apparently took place in the back offices of MUSC in Charleston, where someone misidentified Duke as a PHP contractor. One possibility is that PHP's contract with Duke to do bone-marrow transplants was misconstrued as a liver contract. Another is that Physician's Health Plan was confused with another provider that is also sometimes referred to as PHP: Partners National Health Plan, a North Carolina insurer that does have a liver-transplant contract with Duke...
...biopsy revealed that Todd was deteriorating fast, headed toward "fulminant hepatic failure." Without a new liver soon, he would die. The family was in no mood to learn, as they did that afternoon from Trotter, that PHP wanted Todd moved to a hospital where it had a capitation contract limiting their financial exposure. Trotter would not tell Kim exactly where they wanted him to go, but it was the University of Alabama Medical Center, approximately 600 miles away...
...didn't ask that Hunter be sent to Chapel Hill, N.C., in the first place and why PHP's "authorization" was not a simple solution to the problem say a lot about managed-care coverage. O'Connor was unaware that his own company had a liver-transplant contract with UNC because it was really not his company that held such contracts in the first place. In the managed-care business, general-health insurers like PHP often farm out high-cost specialties like organ transplants to secondary insurers who "carve out" coverage of these procedures and do separate deals with hospitals...
...chairmanship were it not for the zealous Gingrich. "I served in this House many long years in the minority," he says. "And we were told that we were in the minority, and we were treated as a minority." As a sign of gratitude to Gingrich, Hyde zipped the Contract with America through his committee--even the portions he didn't like...