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Articles 1 - 6 of 6
Full-Text Articles in Law
Medicare's Prospective Payment System At Age Eight: Mature Success Or Midlife Crisis?, Bruce C. Vladeck
Medicare's Prospective Payment System At Age Eight: Mature Success Or Midlife Crisis?, Bruce C. Vladeck
Seattle University Law Review
This Article is necessarily a rather selective (for reasons of brevity and reader tolerance) and even subjective attempt to summarize the experience under PPS to date and to suggest some lessons that might be drawn from that experience for the future reform of PPS itself and of payment systems generally. No attempt will be made here to be comprehensive, to explain all the technical details of an inherently and increasingly complex system, nor even to systematically survey the rapidly growing body of literature. But the few issues and themes that clearly stand out will be the focus of most of …
Hospital-Medical Staff Relations In The Face Of Shifting Institutional Business Strategies: A Legal Analysis, John D. Blum
Hospital-Medical Staff Relations In The Face Of Shifting Institutional Business Strategies: A Legal Analysis, John D. Blum
Seattle University Law Review
This Article will explore, from a legal perspective, the dynamics of the changing relationships between hospitals and their medical staffs. Specifically, the Article will discuss hospital strategies for maximizing the efficiency of their medical staff operations. In this regard, the discussion will encompass two general areas: (1) the use of agreements and policies that restrict access to medical staff membership; and, (2) the development of economic criteria to assess physicians for appointment and reappointment to medical staffs. Both of these general areas of discussion entail significant legal issues that have never been extensively explored and hold the potential to reshape …
Policing Cost Containment: The Medicare Peer Review Organization Program, Timothy Stoltzfus Jost
Policing Cost Containment: The Medicare Peer Review Organization Program, Timothy Stoltzfus Jost
Seattle University Law Review
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 …
How Good A Samaritan? Federal Income Tax Exemption For Charitable Hospitals Reconsidered, James B. Simpson, Sarah D. Strum
How Good A Samaritan? Federal Income Tax Exemption For Charitable Hospitals Reconsidered, James B. Simpson, Sarah D. Strum
Seattle University Law Review
Do contemporary charitable hospitals provide a sufficient community benefit to justify the loss of government revenue caused by their tax exemption? Focusing particularly on federal income tax exemption and on the community benefit derived from the provision of services to persons unable to pay, this Article argues that not all hospitals do. Accordingly, the authors recommend that the Internal Revenue Service issue a Revenue Ruling revising the current standards for federal income tax exemption to encourage charitable hospitals to clearly and explicitly identify and respond to health care needs, including the needs of persons unable to pay, in their local …
Setting New Jersey Hospital Rates: A Regulatory System Under Stress, Bruce Siegel, M.D., M.P.H., Anne Weiss, M.P.P., Diane Lynch, J.D., M.S.
Setting New Jersey Hospital Rates: A Regulatory System Under Stress, Bruce Siegel, M.D., M.P.H., Anne Weiss, M.P.P., Diane Lynch, J.D., M.S.
Seattle University Law Review
This Article reviews the history of hospital rate setting in New Jersey, emphasizing the system's evolution in response to newly perceived problems and changing political forces. The system experienced some early success in controlling cost growth and demonstrating new techniques of hospital rate setting. In later years, rate setting in New Jersey has been less successful at confronting a new federal role and the growing problem of health care access. The problems faced by New Jersey hold lessons for both the federal government as it pursues cost containment and the other states who either operate rate regulation systems or contemplate …
Private Utilization Review, Marvis J. Oehm
Private Utilization Review, Marvis J. Oehm
Seattle University Law Review
This Article describes the history of private UR and provides illustrations of successes, problems and controversies. The Article concludes with some suggestions and prescriptive advice for those who are likely to encounter UR, either through work with particular clients or directly as part of a private benefit plan.