Law Commons^™

Countering Pay-For-Performance's Unintended Consequences By Rethinking The Physician's Duty To Disclose, Mariah Dick

Health Matrix: The Journal of Law-Medicine

The article highlights the features of the U.S. Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and identify those attributes that make it vulnerable to the same types of unintended behaviors that have plagued pay-for-performance models in other industries. Topics discussed include unintended consequences associated with pay-for-performance in non-health care industries; physician disclosure standards; and need of laws for patient-centered care and patient autonomy.

Step Therapy: Legal And Ethical Implications Of A Cost-Cutting Measure, Sharona Hoffman

Faculty Publications

The very high and ever-increasing costs of medical care in the United States are well-recognized and much discussed. Health insurers have employed a variety of strategies in an effort to control their expenditures, including one that is common but has received relatively little attention: step therapy. Step therapy programs require patients to try less expensive treatments and find them to be ineffective or otherwise problematic before the insurer will approve a more high-priced option. This Article is the first law journal piece dedicated to analyzing this important cost control measure.

The Article explores the strengths and weaknesses of step therapy …