Reviews

Susan Gross Solomon (ed.), Beyond Sovietology: Essays in Politics and History. New York and London: M.E. Sharpe, 1993, 254 pp., £38.00.

Alice H. Amsden, Jacek Kochanowicz & Lance Taylor, The Market Meets Its Match. Restructuring the Economics of Eastern Europe. Cambridge, MA: Harvard University Press, 1994, 250 pp.

Robert E. Ebel, Energy Choices in Russia. Washington, DC: Center for Strategic and International Studies, 1994, xii + 152 pp., $16.95.

Michael Waller, The End of the Communist Power Monopoly. Manchester: Manchester University Press, 1993, viii + 287 pp., £35.00 h/b., £9.99 p/b.

Minxin Pei, From Reform to Revolution: The Demise of Communism in China and the Soviet Union. Cambridge, MA: Harvard University Press, 1994, 253 pp., £29.95.

William G. Rosenberg & Lewis H. Siegelbaum (eds), Social Dimensions of Soviet Industrialisation. Bloomington and Indianapolis, IN: Indiana University Press, 1993, xix + 296 pp., £12.99 p/b.

Taras Kuzio & Andrew Wilson, Ukraine: Perestroika to Independence. Basingstoke: Macmil‐lan Press, 1994, xiv + 260 pp., £40.00.

Russell F. Farnen (ed.), Nationalism, Ethnicity, and Identity. Cross National and Comparative Perspectives. New Brunswick, NJ, and London: Transaction, 1994, xiv + 538 pp., £49.95.

Edwin Thomas Bacon, The Gulag at War: Stalin's Forced Labour System in the Light of Archives. Basingstoke: Macmillan, 1994, xii + 190 pp.

Robert S. Ross, China, the United States and the Soviet Union: Tripolarity and Policy Making in the Cold War. Armonk, NY: M. E. Sharpe, 1993, x + 204 pp., £42.00.     

A review of recent developments affecting COBRA rights

Due to the high cost of health care claims and COBRA's status as remedial legislation, COBRA has generated a significant amount of litigation in recent years. While the early COBRA decisions tended to broaden the law in order to provide a remedy to an otherwise uninsured qualified beneficiary, the recent trend in the case law has been to limit the expansion of COBRA rights based on a narrower construction of the statute. Even so, COBRA still represents a legal minefield for employers. As a result, a careful employer will minimize its exposure by monitoring changes in the law and its interpretation and making appropriate modifications to its COBRA documentation and administration. This article discusses some of the more significant recent changes in the law affecting qualified beneficiaries' COBRA rights--and therefore, employers' exposure.     

State Medicaid reform under Section 1115 demonstration authority

Given the complexity of federal Medicaid law and the limitations it imposes on state flexibility, it is likely that states will continue to ask the Secretary to grant waivers under Section 1115 to allow them to pursue new approaches to health care reform. The results of currently operational Section 1115 projects involving statewide managed care systems will be useful in evaluating the Medicaid reform measures currently under discussion in other states and at the federal level. In particular, the ability of the states to control Medicaid and indigent care costs and to utilize federal dollars more efficiently should prove important in evaluating a block grant approach to federal Medicaid funding. Moreover, Section 1115 project results that bear on the sufficiency of various Medicaid capitation rate methodologies will also be of value as more states expand the use of managed care arrangements for their Medicaid populations.     

The Department of Health and Human Services issues proposed regulations on physician incentive payments by hospitals

Hospitals tempted to operate their own physician incentive plans are reminded that, under OBRA 1986, they are precluded from paying physician incentives of any kind to reduce or limit Medicare or Medicaid covered services. In light of the proposed regulations and the guidance of the preamble, hospitals should review their incentive plans to determine whether physicians providing direct patient care are receiving prohibited payments. Further, supervising physicians who are receiving incentives for certain hospital departments may not influence direct care over patients served by those departments, even through other physicians. Some risk may also exist if incentives are based on a formula that considers patients of the supervising physician's medical group. Finally, it may be useful to develop a utilization and quality of care review program specifically designed to assure that patient undertreatment does not occur as a result of any supervising physician incentive program.