In addition, he said, the bylaws can also include a provision permitting reimbursement of legal costs before a final decision in the case.
"The first precaution that should be taken by boards concerned about this issue is to review their bylaws to make sure that all existing loopholes are adequately plugged," Mr. Cholst said, adding that if the bylaws do not permit reimbursement for "judgments, fines, amounts paid in settlement and reasonable expenses," they can be amended to do so.
There are some circumstances where provincial health insurance plans in Canada permit reimbursement of expenses incurred as a result of receiving out-of-country medical care.
Deloitte's 2009 medical tourism industry report highlighted four US health insurers who are piloting health plans that permit reimbursement of elective procedure overseas in Thailand, India and Mexico [ 64].
Lack of time, fee schedule that does not permit reimbursement for telephone consultations and inadequate information systems were also identified as major irritants in day-to-day practice, mainly by the educators.
Other approaches that are likely to require medically unnecessary drug switching include 'reference drug' programmes, which permit reimbursement up to the cost of a preferred drug, and mandatory therapeutic substitution, which requires patients to switch to the cheapest medication in a class [ 8, 10].
–J.N. and W.P.B. Prompted by the notoriety of the Terri Schiavo case, congressmen have proposed bills to encourage health care providers to supply information to patients about living wills and even permit Medicare reimbursement for consultations with a physician about end-of-life planning.
However, arrangements with the World Bank and other financial institutions permit cost reimbursement as a percentage of actual costs incurred, and largely account for the estimated increase in income, under cost increases, of US$215,0000.
We found that 83% of the 12 payer respondents believe they should be permitted to limit reimbursement of certain drugs to patients whose test results indicate they are more likely to benefit.
