Medicare's enduring struggle to define "reasonable and necessary" care.

Neumann, Peter J; Chambers, James D · N Engl J Med · 2012

editorial · Level V

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Abstract

Medicare legislation mandates that the program not pay for items and services that are not "reasonable and necessary" - terms that are open to interpretation and easily politicized. In today's fiscal environment, "reasonable and necessary" warrants a closer look.

Medical subject headings