Health Law and Policy Commons^™

The Current State Of Abortion Law In Virginia Leaves Victims Of Domestic And Sexual Violence Vulnerable To Abuse: Why Virginia Should Codify The Right To Abortion In The State Constitution†, Courtenay Schwartz

University of Richmond Law Review

All people must have access to safe and legal reproductive health care—especially victims of sexual and domestic violence who can and do become pregnant because of the violence they experience. This year, the United States Supreme Court overturned Roe v. Wade and Planned Parenthood of Southeastern Pennsylvania v. Casey in Dobbs v. Jackson Women’s Health Organization. In doing so, the Supreme Court held that the Constitution does not protect the right to an abortion. Though abortion access is currently protected in Virginia, this could change with each new General Assembly session. To guard against the danger that this poses to …

Erisa’S Fiduciary Fantasy And The Problem Of Mass Health Claim Denials, Katherine T. Vukadin

University of Richmond Law Review

Over 100 million Americans face healthcare debt. Most of those in debt have health insurance, with the debt often springing from services people thought were covered. Before and even after receiving care, those seeking coverage must run a gauntlet of obstacles such as excessive pre-authorization requests, burdensome concurrent review of care, and retrospective review, which claws back payment after a treatment is pre-authorized and payment made. Increasingly, this procedural tangle leaves people with unwarranted and unexpected medical bills, quickly spiraling them into debt.

Who polices health insurers’ claims practices? What keeps insurance companies from designing overly burdensome pre-authorization requirements or …

Going The Extra Mile: Expanding The Promoting Affordable Housing Near Transit Act, Emily R. Casey

University of Richmond Law Review

The Promoting Affordable Housing Near Transit Act (“Act”), introduced in Congress in June 2021 and signed into law six months later, proposes a goal of balancing the disproportionately-high costs of housing and transportation felt by lower-income families by combining these resources in one project: transit-oriented housing developments. Middle-income and wealthy suburbanites have ready access to cities by car, but lower-income urbanites lack access to the suburbs without a private vehicle. While the goal of the Act recognizes this disparate outcome, the Act’s failure to include expansion of mass transit into the suburbs will continue to restrict low-income minorities to urban …

Opioid Litigation Panel, Rick Mountcastle, Paul Farrell, Eric Eyre, Patrick C. Mcginley

University of Richmond Law Review

On February 17, 2023, the University of Richmond Law Review hosted a symposium entitled Overlooked America: Addressing Legal Issues in Rural America. A portion of the event focused on the ongoing opioid epidemic in the United States, including the causes and effects of certain actions taken by players in the pharmaceutical industry. The Opioid Litigation Panel, transcribed below, brought together four of the most prominent leaders in the fight for justice in the opioid epidemic: Mr. Rick Mountcastle, Mr. Paul Farrell, Mr. Eric Eyre, and Professor Patrick McGinley. The University of Richmond Law Review was so honored to have …

Duped By Dope: The Sackler Family’S Attempt To Escape Opioid Liability And The Need To Close The Non-Debtor Release Loophole, Bryson T. Strachan

University of Richmond Law Review

The opioid epidemic continues to rage on in the United States, ravaging its rural populations. One of its main causes? OxyContin. Purdue Pharma (“Purdue”), the maker of OxyContin, aggressively marketed opioids to the American public while racking up a fortune of over $13 billion dollars for its owners,3 the Sackler family. As a result, roughly 3,000 lawsuits were filed against Purdue and members of the Sackler family. Generally, the lawsuits alleged that Purdue and members of the Sackler family knew OxyContin was highly addictive yet aggressively marketed high dosages of the drug and misrepresented the drug as nonaddictive and without …

With A Wink And A Nod: How Politicians, Regulators, And Corrupt Coal Companies Exploited Appalachia, Patrick C. Mcginley

University of Richmond Law Review

Environmental regulators treated America’s leading coal companies like Wall Street’s mismanaged banks leading to the “Great Recession”—big coal companies that produced millions of tons of coal were simply too big to fail. With a wink and a nod, federal and state regulators ignored a core provision of federal law that was intended to prevent coal companies from continuing their past practices of plundering Appalachia’s mineral wealth while ravaging her environment.

This Article examines how the coal industry successfully evaded compliance with that law. The consequences of this evasion include mass bankruptcies, thousands of acres of mined land laying unclaimed, …

Duped By Dope: The Sackler Family’S Attempt To Escape Opioid Liability And The Need To Close The Non-Debtor Release Loophole, Bryson T. Strachan

Law Student Publications

The opioid epidemic continues to rage on in the United States, ravaging its rural populations. One of its main causes? OxyContin. Purdue Pharma (“Purdue”), the maker of OxyContin, aggressively marketed opioids to the American public while racking up a fortune of over $13 billion dollars for its owners,3 the Sackler family. As a result, roughly 3,000 lawsuits were filed against Purdue and members of the Sackler family. Generally, the lawsuits alleged that Purdue and members of the Sackler family knew OxyContin was highly addictive yet aggressively marketed high dosages of the drug and misrepresented the drug as nonaddictive and without …

Unmet Legal Needs As Health Injustice, Yael Cannon

University of Richmond Law Review

In Part I, this Article examines the health justice framework through which laws are understood as determinants of health equity. In Part II, this Article argues that when unaddressed for low-income individuals, legal needs serve as social determinants of health. Applying the health justice framework, the Article examines the major domains of social determinants of health (“SDOH”) and identifies areas of law for which unmet legal needs contribute to poor health and health inequity. Specifically, it analyzes how the five major domains of SDOH of the Healthy People 2030 paradigm of the U.S. Department of Health and Human Services (“HHS”) …

Trustworthy Digital Contact Tracing, Emily Berman, Leah R. Fowler, Jessica L. Roberts

University of Richmond Law Review

This Article takes a closer look at digital contact tracing in the United States during the coronavirus pandemic and why it failed. It begins by explaining the shortcomings of traditional analog methods and the resulting need for digital contact tracing. It then turns to the norms regarding consent, the scope of the data collected, and the limits on subsequent use necessary for cooperative surveillance. We argue that any successful digital contact-tracing program must incorporate these elements. Yet while necessary, those strategies alone may not be sufficient. People justifiably lack trust in public health authorities, in new technologies, and in the …

Imagining A Better Public Health (Law) Response To Covid-19, Evan Anderson, Scott Burris

University of Richmond Law Review

This Article is not a thorough-going history of the pandemic response. By way of critique and suggesting a way forward for public health, we are going to imagine how public health—both the official agencies and the interconnected nodes in academia and health systems—might have approached COVID-19 differently. This is a story that focuses on good judgment as the lynchpin of optimal pandemic response and allows us to think about where good judgment seems to have been lacking, and how public health culture and institutions might change to improve the chances of better judgment next time.

The Future Of Wastewater Monitoring For The Public Health, Natalie Ram, Lance Gable, Jeffrey L. Ram

University of Richmond Law Review

This Article thus expands the extant literature by considering the legal and ethical dimensions of wastewater surveillance more thoroughly and more broadly. It arrives at an auspicious time, as the United States moves into a vaccine-mediated phase in which COVID-19 is less likely to give rise to broad stay-at-home orders and more likely to trigger narrower, more targeted interventions. It seeks to offer guidance for the legal and ethical use of wastewater surveillance along two dimensions. The first dimension considers the circumstances under which wastewater monitoring should be deployed for detecting and responding to COVID-19 specifically. The second dimension zooms …

Reforming Age Cutoffs, Govind Persad

University of Richmond Law Review

This Article examines the use of minimum age cutoffs to define eligibility for social insurance, public benefits, and other governmental programs. These cutoffs are frequently used but rarely examined in detail. In Part I, I examine and catalogue policies that employ minimum age cutoffs. These include not only Medicare and Social Security but also other policies such as access to pensions and retirement benefits, eligibility for favorable tax treatment, and eligibility for discounts on governmentally provided goods and services. In Part II, I examine different rationales underlying eligibility and discuss the imperfect fit between these rationales and the use of …

Expanding Medicaid In The Postpartum Period, Madison P. Harrell

University of Richmond Law Review

This Comment will discuss how the current Medicaid law is insufficient to address the issue of disappointing maternal health outcomes in the United States and how the federal government should begin to remedy the problem. First, I will shed light on the maternal health crisis in the United States, before discussing the history of pregnancy and postpartum Medicaid coverage. Then, I will outline the enactment of the Affordable Care Act, the subsequent court battle over its constitutionality, and the effects of that decision on the current landscape of pregnancy and postpartum Medicaid coverage. Finally, I will detail my proposal for …

Expanding Medicaid In The Postpartum Period, Madison P. Harrell

Law Student Publications

This Comment will discuss how the current Medicaid law is insufficient to address the issue of disappointing maternal health outcomes in the United States and how the federal government should begin to remedy the problem. First, I will shed light on the maternal health crisis in the United States, before discussing the history of pregnancy and postpartum Medicaid coverage. Then, I will outline the enactment of the Affordable Care Act, the subsequent court battle over its constitutionality, and the effects of that decision on the current landscape of pregnancy and postpartum Medicaid coverage. Finally, I will detail my proposal for …

Covid-19 And Rule 10b-5, Allan Horwich

University of Richmond Law Review

The COVID-19 pandemic presented wide-ranging challenges for businesses. Not the least of these is compliance with federal securities laws, including the prohibition—most notably under SEC Rule 10b-5—on materially deceptive statements made to the public. Both the SEC, in its role as enforcer of the law, and private parties, seeking to represent classes of aggrieved investors, have filed complaints asserting that corporations and others have engaged in deception of investors regarding matters pertaining to COVID-19. Some of these claims relate to disclosures regarding testing kits for the virus as well as development of vaccines. Other complaints allege faulty disclosure on the …

Mobile Methadone Clinics: A Necessary Step In Fighting The Opioid Epidemic, Laurel E. Via

University of Richmond Law Review

Part I of this Article will discuss the rise in opioid use disorder, the need for effective treatment, and the utility of methadone maintenance treatment options, as well as the history of the ban on mobile clinics. Part II will discuss the NPRM issued by the DEA on February 26, 2020, and explain the likely impact of the rule. Part III will provide an overview of the NPRM in its current form, explain its likely impact as written and show that mobile clinics are effective treatment options, and then argue that while a great start, the NPRM should be amended …

Access Before Evidence And The Price Of The Fda’S New Drug Authorities, Erika Lietzan

University of Richmond Law Review

Sometimes drug innovation seems to happen in reverse. Patients enjoy a treatment for years even though the treatment has not been approved by the FDA or proven safe and effective to the FDA’s standards. (Sometimes this happens because the FDA has declined to take enforcement action.) The agency encourages companies to perform the work necessary to satisfy the United States “gold standard” for new drug approval, however, by promising exclusivity in the marketplace. When a company does this work, at considerable expense, the results are predictable. The new drug is expensive, and patients and payers (and sometimes policymakers) are outraged. …

On Opioids And Erisa: The Urgent Case For A Federal Ban On Discretionary Clauses, Katherine T. Vukadin

University of Richmond Law Review

The American opioid epidemic cuts across all social divisions, touching the employed and unemployed. Those with private health insurance are one of the fastest-growing affected groups, but this group struggles most to get care. Despite their insured status, the privately-insured received treatment at half the rate of those with Medicaid and at even lower rates than the uninsured. This article focuses on a significant barrier to treatment for those in employer sponsored benefit plans: the discretionary clause. A discretionary clause grants the decision maker broad latitude and ensures that any federal court review is deferential. Claims processing in such a …

Health Care Law, Sean P. Byrne, Garrett Hooe

University of Richmond Law Review

No abstract provided.

Renewed Commitment: The Latest Chapter In Reforming Virginia's Mental Health System, The Honorable Jennifer L. Mcclellan

Richmond Journal of Law and the Public Interest

In the wake of the highly publicized Virginia Tech tragedy, the 2008 General Assembly Session adopted mental health reforms that focused on the provision of emergency services during the detention and commitment process, and an increase in funding to implement these reforms and strengthen emergency services. Despite the reforms, the issue of inadequate capacity to meet the increasing demand for mental health services remains in a number of key areas, including emergency services and a decline in in-patient psychiatric bed capacity while population growth continues.

An Analysis Of The Political And Legal Debates Concerning Medicaid Expansion In Virginia, Rick Mayes Ph.D, Benjamin Paul

Richmond Journal of Law and the Public Interest

The Supreme Court's historic June 2012 ruling regarding the Affordable Care Act (ACA) in National Federation of Independent Business v. Sebelius set the stage for a massive federalism battle over Medicaid expansion in the United States. The original language of the Act was intended to nationalize Medicaid by having every state expand their program's eligibility to all individuals up to 138% of the federal poverty level. This would have significantly reshaped Medicaid, a joint federal-state health insurance program, into a universal entitlement for all low-income citizens. Currently, Medicaid eligibility varies dramatically from state to state. The Court held that the …

Renewed Commitment: The Latest Chapter In Reforming Virginia's Mental Health System, The Honorable Jennifer L. Mcclellan

Richmond Public Interest Law Review

In the wake of the highly publicized Virginia Tech tragedy, the 2008 General Assembly Session adopted mental health reforms that focused on the provision of emergency services during the detention and commitment process, and an increase in funding to implement these reforms and strengthen emergency services. Despite the reforms, the issue of inadequate capacity to meet the increasing demand for mental health services remains in a number of key areas, including emergency services and a decline in in-patient psychiatric bed capacity while population growth continues.

An Analysis Of The Political And Legal Debates Concerning Medicaid Expansion In Virginia, Rick Mayes Ph.D, Benjamin Paul

Richmond Public Interest Law Review

The Supreme Court's historic June 2012 ruling regarding the Affordable Care Act (ACA) in National Federation of Independent Business v. Sebelius set the stage for a massive federalism battle over Medicaid expansion in the United States. The original language of the Act was intended to nationalize Medicaid by having every state expand their program's eligibility to all individuals up to 138% of the federal poverty level. This would have significantly reshaped Medicaid, a joint federal-state health insurance program, into a universal entitlement for all low-income citizens. Currently, Medicaid eligibility varies dramatically from state to state. The Court held that the …

Dispatch From The Culture War: Virginia's Failed Hpv Vaccination Mandate, Rachel Reynolds

Law Student Publications

This paper will inquire into what makes Gardasil different from other vaccines, and how that impacts its administration. Part I will describe the specifics of the HPV vaccine: how it works and how Virginia decided to promote its usage. Part II will examine the ways in which jurisdictions have traditionally understood vaccination policy, and contrast it with the ways in which they have handled the HPV vaccine. Part III will examine the disadvantages of continuing the mandate’s ineffective political war of attrition, and suggest a coalition-building strategy to effect policy that honors communal values and meaningfully increases access to the …

The Rhetoric Hits The Road: State Challenges To The Affordable Care Act Implementation, Elizabeth Weeks Leonard

University of Richmond Law Review

No abstract provided.

Why Virginia's Challenges To The Patient Protection And Affordable Care Act Did Not Invoke Nullification, Robert S. Claiborne Jr.

Law Student Publications

This comment's focus is to convincingly demonstrate that neither the General Assembly's Health Care Freedom Act nor the Commonwealth's constitutional challenge to the minimum essential coverage provision were exercises of nullification. Part II of this comment relates a brief history of the ACA's passage alongside the Virginia Health Care Freedom Act's enactment and the Attorney General of Virginia Ken Cuccinelli's suit against Secretary of Health and Human Services Kathleen Sebelius. Part III defines nullification and further explains it through the historical instances when Virginia has considered the doctrine. Part IV demonstrates that-far from nullifying the minimum essential coverage provision-Virginia has …

Virginia's War On Women: How Forcing Women To Have An Ultrasound Before Abortion Is Unconstitutional, Alison B. Linas

Richmond Journal of Law and the Public Interest

This comment will discuss how the ultrasound bill, like similar ones in other states, is unconstitutional for two reasons. First, requiring a woman to undergo a medically unnecessary procedure at her own expense is an undue burden under Planned Parenthood v. Casey. Second, the Supreme Court has held that competent people have the right to refuse medical care. By requiring a woman to have an ultrasound, the State is depriving her of her constitutional right to refuse care. Part 11 of this comment will focus on the Supreme Court's role in shaping abortion policy. Part II(A) concerns the history of …

Reproductive Freedom And Virginia's 2012 General Assembly Session, Katherine Greenier

Richmond Journal of Law and the Public Interest

While the Governor approved H.B. 462, the mandatory ultrasound bill, H.B. 62, H.B. 1285, and S.B. 637 failed in the General Assembly.37 As introduced this 2012 session, H.B. 1 contained different bill language than the prior years it has been introduced. H.B. 62, H.B. 1285, and S.B. 637 were new bills, not seen in past years. An analysis and overview of these measures sheds light on the increasing attempts and the tactics used by legislators to undermine reproductive freedom.

Reproductive Freedom And Virginia's 2012 General Assembly Session, Katherine Greenier

Richmond Public Interest Law Review

While the Governor approved H.B. 462, the mandatory ultrasound bill, H.B. 62, H.B. 1285, and S.B. 637 failed in the General Assembly.37 As introduced this 2012 session, H.B. 1 contained different bill language than the prior years it has been introduced. H.B. 62, H.B. 1285, and S.B. 637 were new bills, not seen in past years. An analysis and overview of these measures sheds light on the increasing attempts and the tactics used by legislators to undermine reproductive freedom.

Dispatch From The Culture War: Virginia's Failed Hpv Vaccination Mandate, Rachel Reynolds

Richmond Journal of Law and the Public Interest

coverage seems to have become overshadowed. This paper will inquire into what makes Gardasil different from other vaccines, and how that impacts its administration. Part I will describe the specifics of the HPV vaccine: how it works and how Virginia decided to promote its usage. Part II will examine the ways in which jurisdictions have traditionally understood vaccination policy, and contrast it with the ways in which they have handled the HPV vaccine. Part III will examine the disadvantages of continuing the mandate's ineffective political war of attrition, and suggest a coalition-building strategy to effect policy that honors communal values …