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2006

Health Law and Policy

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Full-Text Articles in Law

A Report From The Forum Session "Complexity, Coordination And Compromise: States And The Medicare Drug Benefit" (August 4, 2006), Lee Partridge Dec 2006

A Report From The Forum Session "Complexity, Coordination And Compromise: States And The Medicare Drug Benefit" (August 4, 2006), Lee Partridge

National Health Policy Forum

This National Health Policy Forum meeting report reviews a technical session that took place on August 4, 2006. The invitation-only meeting was designed to discuss implementation issues related to the new Medicare drug benefit, with special consideration of state activities, problems, and concerns. This meeting followed similar ones sponsored by the Forum in 2004 and 2005 in which the state perspective was the primary focus of conversation. Participants, including current and former state Medicaid directors, other state officials and experts, federal officials, Medicare drug plan representatives, and beneficiary advocates, described their experiences during the implementation process and addressed continuing challenges ...


After The Catastrophe: Disaster Relief For Hospitals, Elizabeth Weeks Leonard Dec 2006

After The Catastrophe: Disaster Relief For Hospitals, Elizabeth Weeks Leonard

Scholarly Works

Disaster planning for health care providers following the September 11, 2001, terrorist attacks and, more recently, Hurricane Katrina, focuses on preparing hospitals and other emergency services to respond to victims' medical needs. But little attention has been paid to the challenges that providers would face resuming normal operations after responding to the catastrophe. A large-scale catastrophe could create unprecedented demand for health care and emergency services. Hospitals already struggle to fulfill the high demand for and high costs of emergency care. Following a major disaster, hospitals would face additional financial challenges. Strained capacity and financial reserves, may force hospitals to ...


Personal Health Records: The People's Choice?, Lisa Sprague Nov 2006

Personal Health Records: The People's Choice?, Lisa Sprague

National Health Policy Forum

Information technology (IT), especially in the form of an electronic health record (EHR), is touted by many as a key component of meaningful improvement in health care delivery and outcomes. A personal health record (PHR) may be an element of an EHR or a stand-alone record. Proponents of PHRs see them as tools that will improve consumers’ ability to manage their care and will also enlist consumers as advocates for widespread health IT adoption. This issue brief explores what a PHR is, the extent of demand for it, issues that need to be resolved before such records can be expected ...


Value-Based Coverage Policy In The United States And The United Kingdom: Different Paths To A Common Goal, Wilhelmine Miller Nov 2006

Value-Based Coverage Policy In The United States And The United Kingdom: Different Paths To A Common Goal, Wilhelmine Miller

National Health Policy Forum

This background paper traces the development within American health care of two interrelated trends and activities: an evidence-based approach to medical practice and the critical evaluation of new technologies with respect to their costs and effectiveness. Over the past 35 years each of these developments has increasingly shaped the coverage decisions of public and private health insurers, and their importance for coverage policy is certain to grow. The paper also contrasts the different approaches to such “evidence-” or “value-based” coverage policy in the mixed public and private U.S. health care enterprise with the approach taken in Great Britain’s ...


Medicare And Mental Health: The Fundamentals, Christopher Loftis, Eileen Salinsky Nov 2006

Medicare And Mental Health: The Fundamentals, Christopher Loftis, Eileen Salinsky

National Health Policy Forum

This background paper provides a review of mental health coverage in the Medicare program. It examines the prevalence of mental disorders among Medicare beneficiaries, treatment available through Medicare, and the cost of such treatment. A brief summary of relevant policy issues is provided, including Medicare’s outpatient mental health limitation and the potential effect of the prescription drug benefit on the provision of mental health services.


Epsdt: Medicaid's Critical But Controversial Benefits Program For Children, Christie Provost Peters Nov 2006

Epsdt: Medicaid's Critical But Controversial Benefits Program For Children, Christie Provost Peters

National Health Policy Forum

The Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program under Medicaid provides the most comprehensive set of health benefits for children and adolescents in the public or private sector. A cornerstone of early childhood preventive and treatment services in the nation’s health care “safety net,” the EPSDT program serves nearly 30 million low-income children, including children with disabilities and special needs. Over the years, states have expressed frustration with the administrative burdens of EPSDT requirements. Rising Medicaid costs have put all Medicaid benefits, including the EPSDT program, in the budgetary crosshairs. This issue brief reviews the fundamental characteristics ...


Updating Medicare's Physician Fees: The Sustainable Growth Rate Methodology, Laura A. Dummit Nov 2006

Updating Medicare's Physician Fees: The Sustainable Growth Rate Methodology, Laura A. Dummit

National Health Policy Forum

Medicare’s method to annually update the fees it pays physicians has been under fire for some time—specifically, since the method determined that physician fees should be reduced rather than increased. The update method, called the sustainable growth rate (SGR), was implemented to control the growth in Medicare physician spending. Yet Congress, in response to physician concerns about beneficiary access to care, has acted to avert physician fee cuts since 2003. Although this signals dissatisfaction with the SGR methodology, there is yet to be a widely accepted physician fee update proposal that balances federal budgetary realities with the need ...


The Nuts And Bolts Of Pdps, Mary Ellen Stahlman Nov 2006

The Nuts And Bolts Of Pdps, Mary Ellen Stahlman

National Health Policy Forum

This issue brief provides an overview of Medicare prescription drug plans (PDPs), with a focus on fundamentals such as enrollment, premiums, formularies, cost sharing, prices, payment, cost management, and appeals and grievance processes. It also highlights major changes to the PDP landscape between 2006 and 2007.


Updating The Wic Food Packages: It's About Time, Jessamyn Taylor Nov 2006

Updating The Wic Food Packages: It's About Time, Jessamyn Taylor

National Health Policy Forum

This issue brief reviews key revisions to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program proposed by the USDA, which are based substantially on recommendations by the Institute of Medicine. Should the changes become regulation, they will be the most significant revision of the WIC food packages in over 25 years. This brief describes the changes, the impetus for their consideration, and possible implementation issues from the perspectives of vendors, state and local WIC agencies, and participants.


Medicare Physician Payments And Spending, Laura A. Dummit Oct 2006

Medicare Physician Payments And Spending, Laura A. Dummit

National Health Policy Forum

The Medicare program’s physician payment method is intended to control spending while ensuring beneficiary access to physician services, but there are signs that it may not be working. The physician’s role in the health care delivery system as the primary source of information and treatment options, together with growing demand for services and the imperfect state of knowledge about appropriate service use, challenge Medicare’s ability to achieve these two goals. This issue brief describes the history of physician spending and the contribution of escalating service use and intensity of services to the rise in Medicare outlays, setting ...


Health Information Technology In The United States: The Information Base For Progress, David Blumenthal, Catherine M. Desroches, Karen Donelan, Sara J. Rosenbaum, Timothy Ferris Oct 2006

Health Information Technology In The United States: The Information Base For Progress, David Blumenthal, Catherine M. Desroches, Karen Donelan, Sara J. Rosenbaum, Timothy Ferris

Health Policy and Management Faculty Publications

Health information technology (HIT) has the potential to advance health care quality by helping patients with acute and chronic conditions receive recommended care, diminishing disparities in treatment and reducing medical errors. Nevertheless, HIT dissemination has not occurred rapidly, due in part to the high costs of electronic health record (EHR) systems for providers of care—including the upfront capital investment, ongoing maintenance and short-term productivity loss. Also, many observers are concerned that, if HIT follows patterns observed with other new medical technologies, HIT and EHRs may diffuse in ways that systematically disadvantage vulnerable patient populations, thus increasing or maintaining existing ...


Mid-Atlantic Ethics Committee Newsletter, Fall 2006-Winter 2007 Oct 2006

Mid-Atlantic Ethics Committee Newsletter, Fall 2006-Winter 2007

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.


Who Decides Whether A Patient Lives Or Dies?, Diane E. Hoffmann, Jack Schwartz Oct 2006

Who Decides Whether A Patient Lives Or Dies?, Diane E. Hoffmann, Jack Schwartz

Faculty Scholarship

No abstract provided.


The Brain-Disordered Defendant: Neuroscience And Legal Insanity In The Twenty-First Century, Richard E. Redding Oct 2006

The Brain-Disordered Defendant: Neuroscience And Legal Insanity In The Twenty-First Century, Richard E. Redding

Working Paper Series

Brain-damaged defendants are seen everyday in American courtrooms, and in many cases, their criminal behavior appears to be the product of extremely poor judgment and self-control. Some have a disorder in the frontal lobes, the area of the brain responsible for judgment and impulse control. Yet because defendants suffering from frontal lobe dysfunction usually understand the difference between right and wrong, they are unable to avail themselves of the only insanity defense available in many states, a defense based on the narrow McNaghten test. “Irresistible impulse” (or “control”) tests, on the other hand, provide an insanity defense to those who ...


On Disposable People And Human Well-Being: Health, Money And Power, Berta E. Hernández-Truyol Oct 2006

On Disposable People And Human Well-Being: Health, Money And Power, Berta E. Hernández-Truyol

UF Law Faculty Publications

The foundational premise of this essay is that health and well-being are human rights issues. My focus on this theme, specifically within the human rights paradigm, is new, passionate, and personal. On December 15, 2005, just three months before the conference that prompted the writing of this essay, I lost my partner of over 20 years. She fought a valiant, strong, and dignified fight against cancer--a journey I traveled with her. During that time I learned much about health systems and health care. Most saliently, notwithstanding the reality of the extraordinarily good care she ultimately received, I realized there is ...


Extended Work Duration And The Risk Of Self-Reported Percutaneous Injuries In Interns, Dean M. Hashimoto, Najib T. Ayas, Laura K. Barger, Brian E. Cade, Bernard Rosner, John W. Cronin, Frank E. Speizer, Charles A. Czeisler Sep 2006

Extended Work Duration And The Risk Of Self-Reported Percutaneous Injuries In Interns, Dean M. Hashimoto, Najib T. Ayas, Laura K. Barger, Brian E. Cade, Bernard Rosner, John W. Cronin, Frank E. Speizer, Charles A. Czeisler

Boston College Law School Faculty Papers

Context: In their first year of postgraduate training, interns commonly work shifts that are longer than 24 hours. Extended-duration work shifts are associated with increased risks of automobile crash, particularly during a commute from work. Interns may be at risk for other occupation-related injuries.

Objective: To assess the relationship between extended work duration and rates of percutaneous injuries in a diverse population of interns in the United States.

Design, Setting, and Participants: National prospective cohort study of 2737 of the estimated 18 447 interns in US postgraduate residency programs from July 2002 through May 2003. Each month, comprehensive Web-based surveys ...


Law & Health Care Newsletter, V. 14, No. 1, Fall 2006 Sep 2006

Law & Health Care Newsletter, V. 14, No. 1, Fall 2006

Law & Health Care Newsletter

No abstract provided.


Effects Of Food Marketing To Kids: I'M Lovin' It?, Eileen Salinsky Aug 2006

Effects Of Food Marketing To Kids: I'M Lovin' It?, Eileen Salinsky

National Health Policy Forum

This issue brief reviews key findings and recommendations from the Institute of Medicine study on food marketing and its effects on childhood obesity. The brief describes the childhood obesity epidemic, discusses key trends associated with rising childhood obesity rates, and considers the relative role of marketing practices on diet and obesity within the broader context of complex contributory factors. The brief also summarizes the current legal framework for regulating marketing directed at children; discusses voluntary, self-regulatory mechanisms; and highlights proposals to re-orient marketing practices to combat childhood obesity.


Doctors, Apologies, And The Law: An Analysis And Critique Of Apology Laws, Marlynn Wei Aug 2006

Doctors, Apologies, And The Law: An Analysis And Critique Of Apology Laws, Marlynn Wei

Student Scholarship Papers

This article analyzes and critiques apology laws, their potential use, and effectiveness, both legally and ethically, in light of the strong professional norms that shape physicians’ reaction to medical errors. Physicians are largely reluctant to disclose medical errors to patients, patients’ families, and even other physicians. Some states have passed so-called apology laws in order to encourage physicians to disclose medical errors to patients. Apology laws allow defendants to exclude statements of sympathy made after accidents from evidence in a liability lawsuit. This piece examines potential barriers to physicians’ disclosure of medical mistakes and demonstrates how the underlying problem may ...


A Closer Look At The Medicare Part D Low–Income Benchmark Premium: How Low Can It Go?, Mary Ellen Stahlman Aug 2006

A Closer Look At The Medicare Part D Low–Income Benchmark Premium: How Low Can It Go?, Mary Ellen Stahlman

National Health Policy Forum

This issue brief explains how the Medicare Part D low–income benchmark premium is calculated, what factors influence the level of the low-income benchmark premium in any given year, and the implications of the benchmark amount for Medicare drug plans and beneficiaries as it changes from year to year. The paper provides a simplified, two-year example of how the low-income benchmark premium is calculated in order to illustrate the key factors that influence it.


Oy Canada! Trade's Non-Solution To "The Problem" Of U.S. Drug Prices, Daniel Gilman Aug 2006

Oy Canada! Trade's Non-Solution To "The Problem" Of U.S. Drug Prices, Daniel Gilman

Faculty Scholarship

Price disparities—price “differentiation” or “discrimination”—in pharmaceuticals markets have, in recent years, been the subject of much discussion. Price sensitivity should come as no surprise: Medicines play an increasingly important role in healthcare, while pharmaceuticals prices continue to rise. When prices vary greatly within markets or between neighboring markets, the pressure towards arbitrage is clear. This paper considers the question whether the re-importation of medicines from Canada or the EU is well advised and argues that it is not. First, we might reasonably question the extent to which we wish, as a matter of policy, to manage pharmaceuticals pricing ...


Premium Assistance In Medicaid And Schip: Ace In The Hole Or House Of Cards?, Cynthia Shirk, Jennifer Ryan Jul 2006

Premium Assistance In Medicaid And Schip: Ace In The Hole Or House Of Cards?, Cynthia Shirk, Jennifer Ryan

National Health Policy Forum

This issue brief explores the use of premium assistance in publicly financed health insurance coverage programs. In the context of Medicaid and the State Children’s Health Insurance Program (SCHIP), premium assistance entails using federal and state funds to subsidize the premiums for the purchase of private insurance coverage for eligible individuals. This paper considers the evolution of premium assistance and some of the statutory and administrative limitations, as well as private market factors, that have prevented widespread enrollment in Medicaid or SCHIP premium assistance programs. Finally, this issue brief offers some ideas for potential legislative and/or programmatic changes ...


Don't Bring Me Your Tired, Your Poor: The Crowded State Of America's Emergency Departments, Jessamyn Taylor Jul 2006

Don't Bring Me Your Tired, Your Poor: The Crowded State Of America's Emergency Departments, Jessamyn Taylor

National Health Policy Forum

If the time comes, people expect that the emergency department (ED) will have the resources necessary to treat them in a timely, high-quality manner. Increasingly, however, EDs may not be able to meet that expectation. Hospitals in urban areas with large populations, high population growth, and higher-than-average numbers of uninsured are particularly crowded: ambulances are often diverted to other hospitals and patients are frequently forced to “board” in the hallways (while they wait to be transferred to another facility or part of the hospital). This issue brief places EDs in the context of the U.S. health care system and ...


Mid-Atlantic Ethics Committee Newsletter, Summer 2006 Jul 2006

Mid-Atlantic Ethics Committee Newsletter, Summer 2006

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.


Drugged, Carl E. Schneider Jul 2006

Drugged, Carl E. Schneider

Articles

The Supreme Court's recent decision in Gonzales v. Oregon, like its decision last year in Gonzales v. Raich (the "medical marijuana" case), again raises questions about the bioethical consequences of the Controlled Substances Act. When, in 1970, Congress passed that act, it placed problematic drugs in one of five "schedules," and it authorized the U.S. attorney general to add or subtract drugs from the schedules. Drugs in schedule II have both a medical use and a high potential for abuse. Doctors may prescribe such drugs if they "obtain from the Attorney General a registration issued in accordance with ...


The Electronic Health Record In Practice: Why, How, And What Next?, Lisa Sprague, Sally Coberly Jun 2006

The Electronic Health Record In Practice: Why, How, And What Next?, Lisa Sprague, Sally Coberly

National Health Policy Forum

This local site visit was intended to allow participants to observe the electronic health record (EHR) as used in practice by two U.S. leaders in technology and quality, the Veterans Health Administration (VHA) and Kaiser Permanente (KP). The VHA has employed an EHR system since 1997; KP is in the process of implementing a standard system for all clinicians nationwide. The site visit was designed to provide an opportunity for participants to explore both the expected benefits from EHR adoption and the specific lessons these two large, integrated delivery systems have learned in their transition from paper to electronic ...


Tobacco Regulation Review, V. 5, No. 1, June 2006 Jun 2006

Tobacco Regulation Review, V. 5, No. 1, June 2006

Tobacco Regulation Review

No abstract provided.


National Institutes Of Health State-Of-The-Science Conference Statement: Cesarean Delivery On Maternal Request, Karen H. Rothenberg Jun 2006

National Institutes Of Health State-Of-The-Science Conference Statement: Cesarean Delivery On Maternal Request, Karen H. Rothenberg

Faculty Scholarship

No abstract provided.


Patient Safety, Medical Error And Tort Law: An International Comparison, Joan M. Gilmour May 2006

Patient Safety, Medical Error And Tort Law: An International Comparison, Joan M. Gilmour

Commissioned Reports, Studies and Public Policy Documents

No abstract provided.


La Story: Improving Care Management For The Chronically Ill And Chronically Underserved, Eileen Salinsky, Jessamyn Taylor Apr 2006

La Story: Improving Care Management For The Chronically Ill And Chronically Underserved, Eileen Salinsky, Jessamyn Taylor

National Health Policy Forum

This Los Angeles-based site visit examined safety net and private sector efforts to improve care coordination for underserved and vulnerable populations, including the homeless, the uninsured, the undocumented, and individuals with chronic conditions like diabetes, asthma, and severe mental illness. The visit highlighted challenges and innovations in the use of disease management programs, information systems, performance incentives, and managed care as tools for improving care coordination.