Law Commons^™

Section 1115 Waivers: Innovation Through Experimentation, Or Stagnation Through Routine?, Nicole Johnson

Emory Law Journal

The Medicaid program operates as a federal-state partnership, in which the states agree to meet certain federally mandated requirements in exchange for federal matching funds for program expenditures. These federal matching funds can be anywhere from 50–90% of health care expenses incurred through state Medicaid programs. As such, states have a substantial interest in continuing this partnership and ensuring that their state plans comply with federal requirements. There is a way, though, in which states can gain more freedom in building their individual state plans. Through section 1115 waivers, states can ask the Centers for Medicare and Medicaid Services (“CMS”) …

Missing The Forest For The Trees: Why Supplemental Needs Trusts Should Be Exempt From Medicaid Determinations, Jeffrey R. Grimyser

Chicago-Kent Law Review

Supplemental needs trusts are trusts designed to assist individuals with disabilities by paying for services and items that Medicaid will not pay for. Federal law, however, is unclear as to whether using one of these trusts automatically disqualifies someone from receiving Medicaid, thereby causing the circuit courts to split on their interpretation. Some circuits have held that the Medicaid statute allows states to enact laws prohibiting the use of these trusts while receiving Medicaid benefits based on the federal law’s statutory language. While other circuits have ruled that individuals can simultaneously receive Medicaid benefits and use supplemental needs trusts given …

A Broke(N) System: Comment On The Supreme Court's Decision To Rule On The Equal Access Provision In Douglas V. Independent Living Center, And Its Potential Impact On The Affordable Care Act, Megan Waugh

Journal of the National Association of Administrative Law Judiciary

This comment first provides a historical and legal backdrop of the Medicaid system, the Equal Access Provision and private individuals' enforcement of the Equal Access Provision through litigation in order to analyze the outcome of Douglas in light of the Supreme Court's decision in the Affordable Care Act Case. Then taking that analysis, this article recommends an approach to handle either a cause of action or no cause of action under the Supremacy Clause upon the implementation of PPACA.

Kicking Ohio Medicaid Recipients When They Are Down: How Ohio's Third Party Liability Medicaid Statute Violates Federal Law As Interpreted By Ahlborn, Kelly Voyles

Cleveland State Law Review

This Note argues that Ohio’s Medicaid third party liability statute must either be invalidated by the Ohio Supreme Court or repealed by the Ohio General Assembly. This Note then goes on to argue that the Ohio General Assembly must amend its Medicaid third party liability statute to require settlement allocation before ODJFS can recover the medical payments it made on behalf of Ohio Medicaid recipients. Finally, this Note argues that Ohio should also amend its Medicaid third party liability statute to require that the parties come to an allocation agreement themselves or, if that proves impossible, to require a judicial …

Access To Medicaid: Recognizing Rights To Ensure Access To Care And Services, Colleen Nicholson

University of Michigan Journal of Law Reform Caveat

The Supreme Court has defined Medicaid as “a cooperative federal-state program through which the Federal Government provides financial assistance to States so that they may furnish medical care to needy individuals.” In June 2012, the Court found the Patient Protection and Affordable Care Act’s (PPACA) Medicaid expansion unconstitutional. The Court took issue with the threat to withhold all of a state’s Medicaid funding if they did not comply with the expansion, finding it coercive and a fundamental shift in the Medicaid paradigm. However, Medicaid in its current form may not always be effective at providing beneficiaries with timely access to …

Why Don't Doctors & Lawyers (Strangers In The Night) Get Their Act Together?, Frances H. Miller

Michigan Law Review

Health care in America is an expensive, complicated, inefficient, tangled mess - everybody says so. Patients decry its complexity, health care executives bemoan its lack of coherence, physicians plead for universal coverage to simplify their lives so they can just get on with taking care of patients, and everyone complains about health care costs. The best health care in the world is theoretically available here, but we deliver and pay for it in some of the world's worst ways. Occam's razor ("Among competing hypotheses, favor the simplest one") is of little help here. There are no simple hypotheses - everything …

Two Wrongs Don't Make A Right: Medicaid, Section 1983 And The Cost Of An Enforceable Right To Health Care, Mark A. Ison

Vanderbilt Law Review

More than a trillion dollars annually is spent on the health care system .... Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation .... Despite our Nation's wealth, the health care system does not provide coverage to all Americans who want it. These words capture both the essence of America's public health care dilemma and the frustration felt by many of the lawmakers charged with the duty to solve it. The battle to lower …

Health Care Law, Peter M. Mellette, Emily W. G. Towey, J. Vaden Hunt

University of Richmond Law Review

No abstract provided.

Smoke And Mirrors: Florida's Tobacco-Related Medicaid Costs May Turn Out To Be A Mirage, Christopher May

Vanderbilt Law Review

Since the 1950s, anti-tobacco forces and the United States government have widely publicized the harm that the consumption of cigarettes can cause to humans. Smoking causes diseases of the oral cavity, cardio-pulmonary system, larynx, and bladder. In addition, the use of tobacco may also be related to sterility, ulcers, cancers of several internal organs, and even blindness. The severity of the consequences increases with the amount of consumption.

Experts estimate that 400,000 Americans die each year from smokings almost one out of every five deaths. In addition, the Surgeon General reports that as many as 2,400 deaths occur annually because …

Equal Protection: New York State Clinical Laboratory Ass'n Inc. V. Kaladjian

Touro Law Review

No abstract provided.

Honor Thy Father And Mother: Paying The Medical Bills Of Elderly Parents, Renae Reed Patrick

University of Richmond Law Review

As the elderly population increases and medical costs skyrocket, federal and state governments feel increasing pressures to diminish drains on government treasuries caused by the provision of medical care to the elderly. One possible solution would be to require children to shoulder more of the costs of caring for their parents than they already bear as federal and state taxpayers. This article examines this approach and suggests that such a policy is contrary to both federal and state laws.