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Articles 1 - 11 of 11
Full-Text Articles in Insurance Law
Bad Company? The Rise (Again) Of Association Health Plans, Brendan Williams
Bad Company? The Rise (Again) Of Association Health Plans, Brendan Williams
The Journal of Business, Entrepreneurship & the Law
This article first examines the rule adopted by the DOL and the criticism it has drawn. It then assesses the state of the small-group insurance market for small businesses, and the flawed approach that the ACA took to assisting them. Finally it takes a look at the uncertain future for small businesses and health insurance, and it suggests new approaches
Dinner For Two: Employer Mandate, Meet Erisa; How Dave & Buster’S Response To The Affordable Care Act’S Employer Mandate May Open The Door For Employees To Seek Erisa Relief, Kendall Victoria Dacey
Dinner For Two: Employer Mandate, Meet Erisa; How Dave & Buster’S Response To The Affordable Care Act’S Employer Mandate May Open The Door For Employees To Seek Erisa Relief, Kendall Victoria Dacey
Pepperdine Law Review
When the Affordable Care Act (ACA) became law in late March, 2010, Dave & Buster’s (D&B) had a choice: it could either comply and offer its full-time employees the minimum health insurance coverage required by the new “employer mandate” or it could ignore the new requirements and incur a penalty. Dissatisfied with either option, D&B made the drastic decision to circumvent the ACA entirely, and reduced its full-time staff below the ACA’s employee threshold so as to avoid triggering any penalty or having to pay increased health care costs. However, by dodging the employer mandate, D&B may have come in …
Hospital Chargemaster Insanity: Heeling The Healers, George A. Nation Iii
Hospital Chargemaster Insanity: Heeling The Healers, George A. Nation Iii
Pepperdine Law Review
Hospital list prices, contained in something called a chargemaster are insanely high, often running 10 times the amount that hospitals routinely accept as full payment from insurers. Moreover, the relative level of a particular hospital’s chargemaster prices bears no relationship to either the quality of the services the hospital provides or, to the cost of the services provided. The purpose of these fictitious list prices is to serve as a starting point or anchoring point, for negotiations with third-party payers regarding the amount that they will actually pay the hospital for it’s goods and services. Ironically, there is widespread agreement, …
Building A Better Laboratory: The Federal Role In Promoting Health System Experimentation, Kristin Madison
Building A Better Laboratory: The Federal Role In Promoting Health System Experimentation, Kristin Madison
Pepperdine Law Review
While expanding federal involvement in the health care system, the Patient Protection and Affordable Care Act (ACA) preserves states' roles as policy laboratories and private providers' roles as health care delivery laboratories. State-based and provider-based laboratories suffer from many shortcomings, however, as mechanisms to develop, evaluate, and facilitate diffusion of reforms within the health system. This Article argues that the federal government can take steps to address these shortcomings. It first briefly reviews ACA provisions that promote policy and delivery experimentation. It then suggests that by tying funding to policy outcomes, making use of regulatory variation and regulatory menus, and …
Disability Insurance In California, Jan Mark Dudman
Disability Insurance In California, Jan Mark Dudman
Pepperdine Law Review
No abstract provided.
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.
The Independent Medicare Advisory Committee: Death Panel Or Smart Governing?, Robert Coleman
The Independent Medicare Advisory Committee: Death Panel Or Smart Governing?, Robert Coleman
Journal of the National Association of Administrative Law Judiciary
No abstract provided.
Group Life And Health Ins. V. Royal Drug Co.: The Narrowing Exemption Of The Business Of Insurance From Federal Antitrust Scrutiny , Stanley K. Yamada Jr.
Group Life And Health Ins. V. Royal Drug Co.: The Narrowing Exemption Of The Business Of Insurance From Federal Antitrust Scrutiny , Stanley K. Yamada Jr.
Pepperdine Law Review
No abstract provided.
Liability Cure-All For Insidious Disease Claims, Susan Frankewich
Liability Cure-All For Insidious Disease Claims, Susan Frankewich
Pepperdine Law Review
Recent decisions handed down in various circuits have created virtual chaos in predicting the liability and damage amounts of insidious disease claims. At least three substantially divergent theories have been adopted to impute liability to the manufacturers of the disease catalysts. Additionally, a new trust fund concept has been used on a limited basis to reconcile differences in court decisions. The trust fund approach is relatively flexible and simple to apply in apportioning damages for insidious disease claims. The author examines and analyzes these three liability theories. In conclusion, the adoption of the trust fund concept is recommended.
Antitrust And California's New Preferred Provider Organization Legislation: A New Alternative In Health Care Cost Containment , Carol A. Woo
Antitrust And California's New Preferred Provider Organization Legislation: A New Alternative In Health Care Cost Containment , Carol A. Woo
Pepperdine Law Review
No abstract provided.
Health Care Providers Meet Erisa: Are Provider Claims For Misrepresentation Of Coverage Preempted, Jeffrey A. Brauch
Health Care Providers Meet Erisa: Are Provider Claims For Misrepresentation Of Coverage Preempted, Jeffrey A. Brauch
Pepperdine Law Review
No abstract provided.