IN THIS ISSUE

Jack A. Rovner
Douglass G. Hewitt
A federal court of appeals says that some benefit denials are really medical treatment decisions. Medical directors, take heed.
John W. Jones
Federal law restricts the leverage given to negotiators for physician associations. Plans should know what is, and what is not, legal.
Peer-Reviewed
David M. Pariser, MD
The impact of this debilitating disease has been largely underestimated, yet new biologic agents offer significant clinical benefit to those afflicted.
Editor's Memo
John Marcille
Legislation & Regulation
John Carroll
Several attorneys general have joined the U.S. Justice Department in questioning some AWP billing and reimbursement practices in Medicaid and Medicare.
Ethics
Michael S. Victoroff, MD
If a doc is compensated when he schedules a patient visit to convey the routine results of a lipid test, but not when he phones the patient, which behavior will he choose?
The Formulary Files
Tomorrow’s Medicine
Thomas Morrow, MD
It is expected that by 2004, 197 biologic medications will be available. Just what kind of an impact will they have on managed care?
News and Commentary