Quote by John Paul Stevens
To make a coverage decision, doesn't one have to make a medical judgment?
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Summary
This quote implies that when deciding on coverage for a medical procedure or treatment, it is necessary to make a medical judgment. In other words, in order to determine whether an insurance plan or provider should cover a particular medical intervention, professionals need to assess the medical necessity and effectiveness of that intervention. This suggests that making coverage decisions inherently involves evaluating the clinical aspects of a treatment and weighing its potential benefits and risks, emphasizing the importance of medical expertise and knowledge in making such determinations.