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Loopholes In The Affordable Care Act: Regulatory Gaps And Border Crossing Techniques And How To Address Them, Timothy Stoltzfus Jost Nov 2013

Loopholes In The Affordable Care Act: Regulatory Gaps And Border Crossing Techniques And How To Address Them, Timothy Stoltzfus Jost

Timothy S. Jost

Not available.


The Real Constitutional Problem With The Affordable Care Act, Timothy Stoltzfus Jost Nov 2013

The Real Constitutional Problem With The Affordable Care Act, Timothy Stoltzfus Jost

Timothy S. Jost

Not available.


Is Medicaid Constitutional?, Timothy Stoltzfus Jost Nov 2013

Is Medicaid Constitutional?, Timothy Stoltzfus Jost

Timothy S. Jost

Not available.


The Most Important Health Care Legislation Of The Millennium (So Far): The Medicare Modernization Act, Timothy Stoltzfus Jost Nov 2013

The Most Important Health Care Legislation Of The Millennium (So Far): The Medicare Modernization Act, Timothy Stoltzfus Jost

Timothy S. Jost

Whether or not one believes that the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) in fact improves or modernizes Medicare, the legislation obviously changes the program radically. The extent and nature of these changes make the MMA the most important piece of health care legislation to be adopted by Congress to date in this young millennium. The MMA also contains what are arguably the most important amendments to the Medicare program since its creation. This Essay first describes the identifying characteristics of the current Medicare program, then examines the significant changes that the MMA makes in the program, and …


Medicare And Medicaid False Claims: Prohibitions And Sanctions, Timothy Stoltzfus Jost Nov 2013

Medicare And Medicaid False Claims: Prohibitions And Sanctions, Timothy Stoltzfus Jost

Timothy S. Jost

Both state and federal agencies are cracking down on health care professionals who file false Medicare claims, but physicians who make good faith attempts to comply with the law are fairly secure from prosecution, since both criminal and civil penalties must be based on willful or knowing breaches of the law.


The Illinois Gardianship For Disabled Adults Legislation Of 1978 And 1979: Protecting The Disabled From Their Zealous Protectors, Timothy Jost Nov 2013

The Illinois Gardianship For Disabled Adults Legislation Of 1978 And 1979: Protecting The Disabled From Their Zealous Protectors, Timothy Jost

Timothy S. Jost

No abstract provided.


The Supreme Court And The Future Of Medicaid, Timothy Stoltzfus Jost Nov 2013

The Supreme Court And The Future Of Medicaid, Timothy Stoltzfus Jost

Timothy S. Jost

Not available.


The Role Of Competition In Health Care: A Western European Perspective, Timothy Stoltzfus Jost, Diane Dawson, André Den Exter Nov 2013

The Role Of Competition In Health Care: A Western European Perspective, Timothy Stoltzfus Jost, Diane Dawson, André Den Exter

Timothy S. Jost

The Federal Trade Commission and Department of Justice 2004 report Improving Health Care: A Dose of Competition expresses a clear allegiance to competition as the organizing principle for health care. In Europe, by contrast, the key organizing principle of health care systems is solidarity. Solidarity means that all have access to health care based on medical needs, regardless of ability to pay. This is not to say that competition is not important in Europe, but competition must take place within the context of solidarity. This article critiques the report from a European perspective, describes the role of competition in Europe …


Pharmaceutical Research And Manufacturers Of America V. Walsh: The Supreme Court Allows The States To Proceed With Expanding Access To Drugs, Timothy Stoltzfus Jost Nov 2013

Pharmaceutical Research And Manufacturers Of America V. Walsh: The Supreme Court Allows The States To Proceed With Expanding Access To Drugs, Timothy Stoltzfus Jost

Timothy S. Jost

On May 19, 2003, the Supreme Court in Pharmaceutical Research and Manufacturers of America v. Walsh affirmed a court of appeals decision allowing for the implementation of the Maine Act to Establish Fairer Pricing for Prescription Drugs.' The Maine program attempted to leverage the considerable market power of the Medicaid program to force drug companies to offer the state a discount on pharmaceuticals. The state in turn would pass the savings on to its uninsured residents. Manufacturers that refused to negotiate a discount with the state would face the prospect of their products being available to Maine Medicaid recipients only …


The Independent Medicare Advisory Board, Timothy Stoltzfus Jost Nov 2013

The Independent Medicare Advisory Board, Timothy Stoltzfus Jost

Timothy S. Jost

It is a common realization that neither unconstrained markets nor our current political institutions are capable of governing our health care system. The cost of health care is spinning dangerously out of control, yet market forces alone cannot manage these costs because of a host of relatively well-understood market failures. Moreover, our traditional political institutions - Congress and the executive administrative agencies - have also failed us in this respect. These institutions are too driven by special interest politics and too limited in their expertise and vision to control costs. Both Medicare payment formulas and coverage determinations often seem to …


The Uses Of The Social Transformation Of American Medicine: The Case Of Law, Timothy Stoltzfus Jost Nov 2013

The Uses Of The Social Transformation Of American Medicine: The Case Of Law, Timothy Stoltzfus Jost

Timothy S. Jost

Not available.


Professional Sovereignty In A Changing Health Care System: Reflections On Paul Starr's The Social Transformation Of American Medicine, Timothy Stoltzfus Jost, Keith Wailoo, Mark Schlesinger Nov 2013

Professional Sovereignty In A Changing Health Care System: Reflections On Paul Starr's The Social Transformation Of American Medicine, Timothy Stoltzfus Jost, Keith Wailoo, Mark Schlesinger

Timothy S. Jost

Not available.


The American Right-Wing Policy Agenda, Timothy Stoltzfus Jost Nov 2013

The American Right-Wing Policy Agenda, Timothy Stoltzfus Jost

Timothy S. Jost

Right-wing health policy is alive and well in the United States. Pro-business and libertarian health policy advocacy groups, generously funded by right-wing foundations (and, in some instances, by the health care industry), produce a continuous stream of press releases, policy-statements, books, articles, and symposia, as well as testimony before legislative and administrative bodies. Their positions are taken very seriously by the American media, who make certain that right-wing policy experts are represented in any discussion of current health policy issues.


The Joint Commission On Accreditation Of Hospitals: Private Regulation Of Health Care And The Public Interest, Timothy Stoltzfus Jost Jan 2013

The Joint Commission On Accreditation Of Hospitals: Private Regulation Of Health Care And The Public Interest, Timothy Stoltzfus Jost

Timothy S. Jost

No abstract provided.


Policing Cost Containment: The Medicare Peer Review Organization Program, Timothy Stoltzfus Jost Jan 2013

Policing Cost Containment: The Medicare Peer Review Organization Program, Timothy Stoltzfus Jost

Timothy S. Jost

This Article will first examine the problem of health care cost inflation and the payment strategies the Medicare program has adopted to address that problem. It will then discuss the perverse incentives that these payment strategies create, and the role of the PRO program in addressing harmful provider behavior encouraged by those perverse incentives. The Article examines evidence on whether the PRO program is succeeding or failing in this mission, and suggests possible means of improving the effectiveness of the PRO program in policing cost containment. Specifically, it recommends clarifying and strengthening the deterrent role of the PROs, crafting PRO …


Medicare And The Joint Commission On Accreditation Of Healthcare Organizations: A Healthy Relationship?, Timothy Stoltzfus Jost Jan 2013

Medicare And The Joint Commission On Accreditation Of Healthcare Organizations: A Healthy Relationship?, Timothy Stoltzfus Jost

Timothy S. Jost

The economic and political forces driving the program in which health care institutions accredited by the Joint Commission on Accreditations of Healthcare Organizations are deemed to meet Medicare conditions of participation are examined. The Joint Commission should be more rigorous in the application of its accreditation standards and more accountable to the public.


Pegram V. Herdrich: The Supreme Court Confronts Managed Care, Timothy S. Jost Jan 2013

Pegram V. Herdrich: The Supreme Court Confronts Managed Care, Timothy S. Jost

Timothy S. Jost

ERISA, adopted a quarter century ago to reform private pension law, imposed by the end of the twentieth century a seemingly insurmountable barrier to managed care reform. The Supreme Court's decision in Pegram v. Herdrich blocked one path out of the ERISA morass-broader use of breach of ERISA fiduciary obligations suits in federal court. On the other hand, it opened another path to holding HMOs accountable in malpractice cases in state court-and suggested that ERISA might impose fiduciary obligations to disclose incentives on HMOs. It is therefore an important decision. ERISA was intended to give the federal government primary authority …


Comparative And International Health Law, Timothy Stoltzfus Jost Jan 2013

Comparative And International Health Law, Timothy Stoltzfus Jost

Timothy S. Jost

No abstract provided.


The Future Of Medicare, Post Great Society And Post Plus-Choice: Legal And Policy Issues--Foreword, Timothy Stoltzfus Jost Jan 2013

The Future Of Medicare, Post Great Society And Post Plus-Choice: Legal And Policy Issues--Foreword, Timothy Stoltzfus Jost

Timothy S. Jost

No abstract provided.


Rights Of Embryo And Foetus In Private Law, Timothy Stoltzfus Jost Jan 2013

Rights Of Embryo And Foetus In Private Law, Timothy Stoltzfus Jost

Timothy S. Jost

This article summarizes the rights of the embryo and fetus under American law. It was presented as a country report at the World Congress on Comparative Law, and is written primarily for a non U.S. audience. It examines, for example, the legal position of the embryo and fetus with respect to their parents, issues in research involving embryos and fetuses, remedies for torts or crimes against an embryo or fetus, and issues involving stem cell research.


Why Can't We Do What They Do? National Health Reform Abroad, Timothy Stoltzfus Jost Jan 2013

Why Can't We Do What They Do? National Health Reform Abroad, Timothy Stoltzfus Jost

Timothy S. Jost

This article describes how other countries organize and finance their health care systems, and how the performance of those health care systems compares with that of the United States. It also examines why the United States, unlike all other developed countries, has failed to provide universal access to health care services.


Private Or Public Approaches To Insuring The Uninsured: Lessons From International Experience With Private Insurance, Timothy Stoltzfus Jost Jan 2013

Private Or Public Approaches To Insuring The Uninsured: Lessons From International Experience With Private Insurance, Timothy Stoltzfus Jost

Timothy S. Jost

In the recent past a broad consensus has emerged in the United States that the best way to expand coverage of the uninsured is to use tax subsidies to encourage the purchase of private health insurance policies. Many advocates of this approach also call for replacing employment-related group policies with individual policies, and for minimizing regulation of private insurance. Those who advocate these policies, however, have rarely considered the experience that other nations have had with private health insurance. In fact most other countries have private insurance markets, and in many countries private insurance plays a significant role in financing …


Health Courts And Malpractice Claims Adjudication Through Medicare: Some Questions, Timothy Stoltzfus Jost Jan 2013

Health Courts And Malpractice Claims Adjudication Through Medicare: Some Questions, Timothy Stoltzfus Jost

Timothy S. Jost

No abstract provided.


Oversight Of Marketing Relationships Between Physicians And The Drug And Device Industry: A Comparative Study, Timothy Stoltzfus Jost Jan 2013

Oversight Of Marketing Relationships Between Physicians And The Drug And Device Industry: A Comparative Study, Timothy Stoltzfus Jost

Timothy S. Jost

Throughout the world, complex mutually-dependent relationships exist between physicians and pharmaceutical and medical device companies. This articlef ocuses on one particulara spect of these relationships--paymentsm ade by drug and device companies to physicians and their organizations and institutions to market drugs and devices. It is widely believed that drug and device company marketing to physicians creates conflicts of interest that corrupt physician judgment and increase the cost of medical care. This article examines first the economic basis of physician/industry relationships that causes conflicts to arise. It next considers the measures that a number of developed countries have taken to respond …


Our Broken Health Care System And How To Fix It: An Essay On Health Law And Policy, Timothy Stoltzfus Jost Jan 2013

Our Broken Health Care System And How To Fix It: An Essay On Health Law And Policy, Timothy Stoltzfus Jost

Timothy S. Jost

No abstract provided.


Global Health Care Financing Law: A Useful Concept?, Timothy Stoltzfus Jost Jan 2013

Global Health Care Financing Law: A Useful Concept?, Timothy Stoltzfus Jost

Timothy S. Jost

No abstract provided.


A Comparative Study Of The Law Of Palliative Care And End-Of-Life Treatment, Denuta Mendelson, Timothy Stoltzfus Jost Jan 2013

A Comparative Study Of The Law Of Palliative Care And End-Of-Life Treatment, Denuta Mendelson, Timothy Stoltzfus Jost

Timothy S. Jost

No abstract provided.


The Massachusetts Health Plan: Public Insurance For The Poor, Private Insurance For The Wealthy, Self-Insurance For The Rest?, Timothy Stoltzfus Jost Jan 2013

The Massachusetts Health Plan: Public Insurance For The Poor, Private Insurance For The Wealthy, Self-Insurance For The Rest?, Timothy Stoltzfus Jost

Timothy S. Jost

No abstract provided.


Optimizing Qui Tam Litigation And Minimizing Fraud And Abuse: A Comment On Christopher Alexion’S Open The Door, Not The Floodgates, Timothy Stoltzfus Jost Jan 2013

Optimizing Qui Tam Litigation And Minimizing Fraud And Abuse: A Comment On Christopher Alexion’S Open The Door, Not The Floodgates, Timothy Stoltzfus Jost

Timothy S. Jost

No abstract provided.


Commentary: Racial Disparities In Health Care, Timothy S. Jost Jan 2013

Commentary: Racial Disparities In Health Care, Timothy S. Jost

Timothy S. Jost

No abstract provided.