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Must a risk-assuming healthcare provider have an insurance license?
1American Medical Association, Chicago, IL, USA.
Abstract:
With the growth of managed care has come the question of whether a risk-assuming provider organization must be licensed to sell insurance. The debate centers on whether capitation arrangements represent an insurance risk or a business risk and whether states have the right to regulate agreements between providers and self-insured employers. A flexible, reasonable approach will be needed if legislators decide to regulate providers that assume varying degrees of risk.
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