Randall & Hurley, Inc.
Loren D. Stark Company
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|TPAs Can Make Mixed Eligibility/Treatment Decisions That Subject Them to State-Law Challenges|
Thompson Publishing Group
Sept. 12, 2002
Excerpt: A federal district court ruled that third-party administrators (TPAs) can be subject to state-law claims if they use health care providers to make medical necessity determinations; such determinations would be classified as mixed eligibility and treatment decisions.
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