Policing Medicaid and Medicare Managed Care: The Role of Courts and Administrative Agencies

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The Role of Courts and Administrative Agencies Michelle M. Mello Harvard School of Public Health Abstract: The much-publicized 2000 case of Frew v. Gilbert, in which a federal judge castigated the State of Texas for deficiencies in its Medicaid program, brought renewed attention to the issue of regulating the quality of care in Medicaid and Medicare HMOs. Frew and other recent cases highlight both the promise and the pitfalls of relying on courts to correct deficiencies in public managed care programs