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Full-Text Articles in Law
The Supreme Court's Limitation Of Managed-Care Liability, Wendy K. Mariner
The Supreme Court's Limitation Of Managed-Care Liability, Wendy K. Mariner
Faculty Scholarship
This article summarizes and critiques the U.S. Supreme Court's decision in Aetna Health Inc. v. Davila, which limited managed care organizations' liability for negligent decisions about the care of patients in private employer-sponsored health plans governed by ERISA. It contrasts the Court's dichotomous view of health benefit plans, in which insurers administer contracts and treating physicians make medical judgments, with the more complicated relationships that affect decisions about both coverage and treatment.
The Changing World Of Employee Benefits, Maria O'Brien Hylton
The Changing World Of Employee Benefits, Maria O'Brien Hylton
Chicago-Kent Law Review
The employee benefits picture, at least for many plan participants and some plan sponsors, is a scary and bleak one. The number of workers with pension coverage is declining, health insurance rates are rising much faster than the rate of inflation, and the number of uninsured continues to rise as well. The decline in union density, the recent boost given by the U.S. Supreme Court to Any Willing Provider ("AWP") laws, and the deluge of recent benefits-related scandals are also all part of this landscape. This Article examines each of these issues, with a focus on reforms that would increase …
Commentary: Is It Time To Take The Broom And Really Clean House? A New Paradigm For Employee Benefits, Mary Ellen Signorille
Commentary: Is It Time To Take The Broom And Really Clean House? A New Paradigm For Employee Benefits, Mary Ellen Signorille
Chicago-Kent Law Review
No abstract provided.
Liberty, Justice, And Insurance For All: Re-Imagining The Employment-Based Health Insurance System, Carolyn V. Juárez
Liberty, Justice, And Insurance For All: Re-Imagining The Employment-Based Health Insurance System, Carolyn V. Juárez
University of Michigan Journal of Law Reform
This Note examines the history of employment-based health insurance and the inherent historical limitations that have led to an erosion of health insurance coverage. Based on a review of several studies, this Note argues that the number of uninsured Americans has reached crisis proportions. State reform efforts, legislative proposals, and other proposed solutions have failed to repair the system. Nonetheless, this Note argues that employment-based health care is integral to the structure of national health care. Furthermore, health insurance coverage can be increased by combining employment-based health care with three reforms: large employer mandates, refundable tax credits, and purchasing pools. …
Promise And Perils Of State-Based Road To Universal Health Insurance In The U.S., Carol S. Weissert
Promise And Perils Of State-Based Road To Universal Health Insurance In The U.S., Carol S. Weissert
Journal of Health Care Law and Policy
No abstract provided.
Advancing Toward Universal Coverage: Are States Able To Take The Lead?, Lisa Dubay, Christina Moylan, Thomas R. Oliver
Advancing Toward Universal Coverage: Are States Able To Take The Lead?, Lisa Dubay, Christina Moylan, Thomas R. Oliver
Journal of Health Care Law and Policy
No abstract provided.
Medicaid: Issues And Challenges For Health Coverage Of The Low-Income Population, Diane Rowland
Medicaid: Issues And Challenges For Health Coverage Of The Low-Income Population, Diane Rowland
Journal of Health Care Law and Policy
No abstract provided.
Universal Coverage And The American Health Care System In Crisis (Again), Rick Mayes
Universal Coverage And The American Health Care System In Crisis (Again), Rick Mayes
Journal of Health Care Law and Policy
No abstract provided.
The Insurance Aspects Of Damages, Robert H. Jerry Ii, Douglas R. Richmond
The Insurance Aspects Of Damages, Robert H. Jerry Ii, Douglas R. Richmond
UF Law Faculty Publications
"[I]t is difficult ... to imagine an event or transaction that does not involve insurance in some way." So it is with the most salient event in the lives of Tony and Donna Sabia, whose son Tony John Sabia, or "Little Tony," was born with profound disabilities. In the final analysis, the ability of Tony and Donna to pay for the future medical care and living expenses needed by their son depends on whether they can reach the liability insurance coverage possessed by the health care providers who attended Donna and Little Tony at the time of his birth. It …
Mainstreaming Complementary And Alternative Medicine In The Face Of Uncertainty, Barbara L. Atwell
Mainstreaming Complementary And Alternative Medicine In The Face Of Uncertainty, Barbara L. Atwell
Elisabeth Haub School of Law Faculty Publications
Part I of this article provides an overview of the medical necessity test, and examines the decision-making process pursuant to the test, including who makes coverage determinations and what criteria are used in making them. Part I also sets forth examples of conventional treatments that insurers routinely cover despite their questionable efficacy from a medical necessity perspective. Part II explores CAM disciplines and describes how they differ from conventional medicine. Part III discusses the legal challenges CAM faces and explores the limited extent to which CAM is covered by health insurance and the failure of state laws to provide mandates …
Images Of Health Insurance In Popular Film: The Dissolving Critique, Elizabeth Pendo
Images Of Health Insurance In Popular Film: The Dissolving Critique, Elizabeth Pendo
All Faculty Scholarship
Several recent films have villainized the health insurance industry as central elements of their plots. This Article examines three of those films: Critical Care, The Rainmaker, and John Q. It analyzes these films through the context of the consumer backlash against managed care that began in the 1990s and shows how these films reflect the consumer sentiment regarding health insurance companies and the cost controlling strategies they employ. In addition, the Article identifies three key premises about health insurance in the films that, although exaggerated and incomplete, have significant factual support. Ultimately, the author argues that, despite their passionately critical …
Images Of Health Insurance In Popular Film: The Dissolving Critique, Elizabeth Pendo
Images Of Health Insurance In Popular Film: The Dissolving Critique, Elizabeth Pendo
Articles
Several recent films have villainized the health insurance industry as central elements of their plots. This Article examines three of those films: Critical Care, The Rainmaker, and John Q. It analyzes these films through the context of the consumer backlash against managed care that began in the 1990s and shows how these films reflect the consumer sentiment regarding health insurance companies and the cost controlling strategies they employ. In addition, the Article identifies three key premises about health insurance in the films that, although exaggerated and incomplete, have significant factual support. Ultimately, the author argues that, despite their passionately critical …