title: Unhealthy Determinations: Controlling 'Medical Necessity
abstract: The notion of medical necessity has been the operative tool through which healthcare coverage determinations in the United States have been rendered and justified. Now, for most people, decisions about coverage translate into decisions about healthcare since few people can afford to pay for their own healthcare. The notion of medical necessity constitutes a necessary component of any healthcare system that is committed to providing high-quality healthcare at a sustainable cost. In practice, howe