Law Commons^™

Retooling Tax Subsidies For Health Coverage: Old Ideas, New Politics, Karl Polzer

National Health Policy Forum

This paper describes the tax treatment of health coverage and health care spending and explores the potential impact of recent tax reform proposals. The paper summarizes the criticisms of the current system and analyzes various alternatives including capping the open-ended tax exclusion of health benefits provided by employers and unions, eliminating the exclusion, and establishing a tax credit.

Physician Organizations Assuming Risk: Market And Policy Implications, Sandra Foote, Lisa Sprague

National Health Policy Forum

This issue brief looks at capitation contracting between physician groups and health plans and ways in which financial risk and functional responsibilities may be apportioned. It traces the evolution of capitation contracting in California and the legislative and regulatory issues that have arisen.

Site Visit To Southern California — Plans And Providers: Risk, Accountability, And Staying Power, Lisa Sprague

National Health Policy Forum

This site visit was the second of two focused on managed care operations and market dynamics in California, a state notable for high HMO market penetration and intense competition. In southern California, large physician groups and independent practice associations were highly visible and influential. They had assumed significant financial risk and care management responsibility for patients in HMO plans. The result was a distinctly different model of managed care than existed in other regions of the country. The visit included meetings with leaders from physician organizations and managed care organizations in San Diego and Orange counties, as well as an …

Managed Care And Managed Sentencing — A Tale Of Two Systems, Ronald Weich

All Faculty Scholarship

The daily injustices mount. The front line professionals who administer the system cry out for more discretion to depart from the rigid rules that bind them, Congress finally hears their call, and is poised to enact sweeping reforms.

Are improvements in federal sentencing law on the way? Probably not in the near future. But the new Congress will surely take up proposals to regulate the managed health care industry, and the impending debate over a proposed "Patients' Bill of Rights" law offers important lessons for federal sentencing policy.

At first blush, sentencing reform and health care reform have about as …

Site Visit To Utah And Nevada — Essential Community Health Services On The Frontier, Karen Matherlee, Michael Anzick

National Health Policy Forum

From the opening dinner to the closing summary, this site visit explored the delivery and financing of essential community services for vulnerable populations in the frontier West. A sequel to the Forum's March 30-31, 1998, urban-centered site visit to Philadelphia, Providing Community-Based Primary Care: Nursing Centers, CHCs, and Other Initiatives, the visit spanned 493 miles. It included overview presentations, bus briefings, facility tours, telehealth demonstrations, panel discussions, and wrap-up reviews. Topics included the Utah health marketplace, the demands of emergency preparedness, the development of a patchwork of services along a continuum ranging from preventive care to tertiary referrals and follow-up, …

Mid-Atlantic Ethics Committee Newsletter, Fall-Winter 1998

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

The State Children's Health Insurance Program: How Much Latitude Do The States Really Have?, Richard Hegner

National Health Policy Forum

The State Children's Health Insurance Program (CHIP) — a major program to cover low-income, uninsured children — was passed as part of the Balanced Budget Act of 1997. Its passage was part of a trend of a shifting balance of power between the federal and state governments, particularly in the policy areas of health and social welfare. This issue brief explores the degree of freedom afforded the states by CHIP, the factors guiding state decision making and planning, and the factors influencing the states' various decisions about CHIP. It also discusses state options in four basic areas: participation or nonparticipation …

An Untapped Resource In Addressing Emerging Infectious Diseases: Traditional Healers, Amy Guerin Thompson

Indiana Journal of Global Legal Studies

No abstract provided.

Take Half An Aspirin And Call Your Hmo In The Morning-Medical Malpractice In Managed Care: Are Hmos Practicing Medicine Without A License?, Tom J. Manos

University of Miami Law Review

No abstract provided.

A Tribute To Jonathan Mann: Health And Human Rights In The Aids Pandemic, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

A tribute to Jonathan Mann, former head of the World Health Organization's global AIDS program and a key figure in the early fight against HIV/AIDS. The author discusses Mann's work in health and human rights, prevention of disease, and eliminating social injustice.

Protecting The Confidentiality Of Health Information, Nora Super

National Health Policy Forum

This issue brief focuses on the legislation aimed at protecting the confidentiality of health information. It provides an overview of legislation being considered in 1998 and focuses on three key issues: controlling access to health information, conducting research, and preempting state laws.

Planned Parenthood Of The Columbia/Willamette, Inc. V. American Coalition Of Life Activists (23 F. Supp. 2d 1182 (1998)), Debbie Karet

Buffalo Women's Law Journal

No abstract provided.

Zeneca Pharmaceutical, Inc. V. Eli Lilly: Are Women Being Misled At The Cost Of Their Health?, Suzanne Hill

Buffalo Women's Law Journal

No abstract provided.

Analysis Of People Of The State Of New York, Buffalo Gyn Womenservices, Planned Parenthood Of Rochester/Syracuse Region, Et. Al. V. Operation Rescue National, Et. Al., Lucinda Finley

Buffalo Women's Law Journal

No abstract provided.

Abortion Policies In Different States, Irene Chiu

Buffalo Women's Law Journal

No abstract provided.

Mandatory Reporting Of Domestic Violence: An Inappropriate Response For New York Health Care Professionals, Mia M. Mcfarlane

Buffalo Public Interest Law Journal

No abstract provided.

The Right To Treatment For Involuntarily Committed Sex Offenders In The Wake Of Kansas V. Hendricks, David Depugh

Buffalo Public Interest Law Journal

No abstract provided.

Medicaid Managed Care Contracting For Childhood Lead Poisoning Prevention Services, Elizabeth Wehr, Sara J. Rosenbaum

Center for Health Policy Research

This study reports on provisions relating to childhood lead poisoning prevention services in Medicaid managed care contract documents (service agreements and requests for proposals, RFPS). The provisions were extracted from the managed care contracts data base of the Center for Health Policy Research of the George Washington University Medical Center. The data base was constructed and is updated as part of the Center's ongoing analytic studies.' As with other Center studies of the contract documents, this is a descriptive study of how state Medicaid agencies addressed a series of contracting issues at a specific point in time.* In brief, we …

Communicating To Beneficiaries About Medicare+Choice: Opportunities And Pitfalls, Nora Super

National Health Policy Forum

This issue brief explores the opportunities and potential pitfalls in communicating to beneficiaries about Medicare+Choice. This issue brief also looks at the difficulties inherent in communicating complex information to a diverse group of older individuals as well as at communications and programmatic challenges related to information overload, marketing concerns, lack of uniform standards, lack of infrastructure, and the vulnerability of various subpopulations.

Medicare Coverage And Technology Diffusion: Past, Present, And Future, Robin J. Strongin

National Health Policy Forum

This issue brief provides an overview of the Medicare coverage process. Coverage involves deciding whether or not to pay for a particular service or product. This brief examines Medicare's coverage determination process, which includes technology assessment, payment determination, and the demand for evidence. Options for improving the coverage determination process are reviewed.

Mid-Atlantic Ethics Committee Newsletter, Summer 1998

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Cigarette Law, Daniel Givelber

Indiana Law Journal

No abstract provided.

Lies, Damned Lies, And Narrative, David A. Hyman

Indiana Law Journal

No abstract provided.

Managed Care, Assisted Suicide, And Vulnerable Populations, M. Cathleen Kaveny

Journal Articles

While advocates of physician assisted suicide consider it a core aspect of individual autonomy legalizing the practice is extremely dangerous and puts the most vulnerable members of our society at risk. Legalized physician assisted suicide takes away the autonomy of the decision to die and makes it an option in a flawed healthcare system, where patients are often denied coverage for medical expenses by employer-sponsored benefit plans and medical insurers are concerned primarily with cutting costs spent on each patient. Complexities in the way that physicians are compensated under the current system of managed care is also eroding their responsibility …

Managed Care, Assisted Suicide And Vulnerable Populations, M. Cathleen Kaveny

M. Cathleen Kaveny

No abstract provided.

Erisa Health Plan Denials: Exploring Models For External Review, Karl Polzer

National Health Policy Forum

This paper outlines the current process under the Employee Retirement Income and Security Act (ERISA) by which plan participants can appeal a claim denial as well as changes to the claims procedure requirements being considered by the Department of Labor. It describes state legislative activity in this area and summarizes research describing practices currently in place among managed health care organization. The paper also describes two existing models for external review of managed care plan decisions, one used by the Medicare program and another by the state of Florida.

Pain Management And Palliative Care In The Era Of Managed Care: Issues For Health Insurers, Diane E. Hoffmann

Faculty Scholarship

No abstract provided.

Site Visit To New Jersey — State And County Experiences With Welfare Reform And Access To Health Care, Michael Anzick, Richard Hegner

National Health Policy Forum

This site visit was the second in a series to examine what is occurring at the state and local level with respect to welfare reform, Medicaid, public health, and safety net and other supportive services. During this visit, policymaker discovered how state officials, directors, and front-line staff at urban and suburban county welfare offices are working with clients to move them off the welfare rolls into jobs and providing the support services necessary for job retention; heard from clients about how programmatic changes are affecting them and their families; learned how the role of safety net health care and temporary …

The Fcc And Aids Education: Helping Broadcasters Serve The Public Interest, Jason B. Acton

Federal Communications Law Journal

Despite recent advances in medical technology, AIDS remains a very serious international health threat. Even with the presence of new drug therapies that have helped to prolong the lives of those who suffer from the disease, scientists have been unable to develop a cure. Consequently education remains the primary weapon available in the war against AIDS. Unfortunately, AIDS education initiatives have found little support in the broadcast community. To renew their licenses, broadcasters are required to act in the public interest— requirement that has traditionally required very little. However, given the threat AIDS presents to society, the FCC should require …

Chicago Hope Meets The Chicago School, Gail B. Agrawal

Michigan Law Review

Twenty-five years after the enactment of the Federal Health Maintenance Organization Act and nearly five years after the failure of proposed federal health care reform, managed care has come to dominate the medical marketplace. As a result, the relationships among patients, payers, and physicians have changed fundamentally and dramatically. In this market-driven environment, health care - how much it costs, who receives treatment, and who pays for it - may have surpassed the weather as a topic of everyday conversation at dinner tables and water coolers across the country. In the popular press, reports concerning managed care, usually derogatory, are …