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Regulatory Developments
GAO Targets TRICARE's Provider Network for Military
On March 27, 2003, Marjorie Kanof, Director, Health Care – Clinical and Military Health Care Issues for the U.S. Government Accounting Office (GAO), provided testimony to the House Armed Services Committee, Subcommittee on Personnel, about problems described by beneficiary groups with access to care from TRICARE's providers. In turn, providers described problems they have experienced with low reimbursement rates and the administrative burdens involved with serving TRICARE beneficiaries. See Oversight of the Adequacy of TRICARE's Civilian Provider Network Has Weaknesses (GAO-03-592T) TRICARE, the health care system for the Department of Defense (DOD), provides care for over 8.7 million active duty military personnel and their dependents, as well as military retirees, through Military Treatment Facilities (MTFs) and through its provider network. As Kanof explained, “TRICARE's civilian provider network … is designed to complement the availability of care offered by MTFs [which] supply most of the health care services TRICARE beneficiaries receive. Report Highlights, at 2. TRICARE offers three options to its beneficiaries:
- TRICARE Prime (a managed care network similar to an HMO);
- TRICARE Extra (a preferred providers network); and
- TRICARE Standard (a fee-for-service program).
The GAO found weaknesses with the DOD's civilian provider network due to: “1) flaws in its required provider-to-beneficiary ratios, 2) incomplete reporting on beneficiaries' access to providers, and 3) the absence of a systematic assessment of complaints … ” Id. at 7. In particular, the GAO exp- lained, the provider-to-beneficiary ratios tend to underestimate the number of providers needed in a given area (particularly as to specialists). Moreover, the GAO found that due to problems with the ability of DOD's contractors to access data, the contractors were not able to adequately assess the extent and respond to beneficiary's complaints.
OIG Rejects Management Fee Arrangement for Inpatient Rehabilitation Units
Major Differences In UK, U.S. Copyright Laws
This article highlights how copyright law in the United Kingdom differs from U.S. copyright law, and points out differences that may be crucial to entertainment and media businesses familiar with U.S law that are interested in operating in the United Kingdom or under UK law. The article also briefly addresses contrasts in UK and U.S. trademark law.
The Article 8 Opt In
The Article 8 opt-in election adds an additional layer of complexity to the already labyrinthine rules governing perfection of security interests under the UCC. A lender that is unaware of the nuances created by the opt in (may find its security interest vulnerable to being primed by another party that has taken steps to perfect in a superior manner under the circumstances.
Strategy vs. Tactics: Two Sides of a Difficult Coin
With each successive large-scale cyber attack, it is slowly becoming clear that ransomware attacks are targeting the critical infrastructure of the most powerful country on the planet. Understanding the strategy, and tactics of our opponents, as well as the strategy and the tactics we implement as a response are vital to victory.
Removing Restrictive Covenants In New York
In Rockwell v. Despart, the New York Supreme Court, Third Department, recently revisited a recurring question: When may a landowner seek judicial removal of a covenant restricting use of her land?
Legal Possession: What Does It Mean?
Possession of real property is a matter of physical fact. Having the right or legal entitlement to possession is not "possession," possession is "the fact of having or holding property in one's power." That power means having physical dominion and control over the property.