Law Commons^™

Regulatory Improvement Legislation: Judicial Review Of Provisions Regarding Risk Assessment And Cost-Benefit Analysis, Mary Ann Chirba, Frederick Anderson, E. Donald Elliott, Cynthia Farina, Ernest Gelhorn, John Graham, C. Boyden Gray, Jeffrey Holmstead, Ronald Levin, Lars Noah, Katherine Rhyne, Jonathan Weiner

Cynthia R. Farina

No abstract provided.

Assisted Dying, Charles Baron

Charles H. Baron

No abstract provided.

What Money Cannot Buy: A Legislative Response To C.Rac.K., Adam B. Wolf

University of Michigan Journal of Law Reform

Children Requiring a Caring Kommunity (C.R.A.C.K.) is an organization that pays current or former drug addicts $200 to be sterilized. While generating great public controversy, C.R.A.C.K. is expanding rapidly throughout the country. Its clients are disproportionately poor women of color, who are coerced by the offer of money into permanently relinquishing their reproductive rights. This Note argues that C.R.A.C.K. is a program of eugenical sterilization that cannot be tolerated. Moreover, C.R.A.C.K. further violates settled national public policy by offensively commodifying the ill-commodifiable, by demeaning women, and by starting down a slippery slope with devastating consequences. This Note proposes legislation that …

Increasing Consumer Power In The Grievance And Appeal Process For Medicare Hmo Enrollees, Kenneth J. Pippin

University of Michigan Journal of Law Reform

Federal law requires that Health Maintenance Organizations (HMOs) and Managed Care Organizations (MCOs) provide Medicare beneficiaries with specific grievance and appeal rights for challenging adverse decisions of these organizations. The Health Care Financing Administration (HCFA) is charged with enforcing these regulations. Currently, however, HCFA contracts with HMOs, allowing them to enroll Medicare beneficiaries despite the fact that many of the statutory and regulatory requirements are ignored by the Medicare HMOs. This is problematic because the elderly Medicare population may not be able to independently and adequately challenge the HMO's denial of care or reimbursement. Because HCFA has been reluctant and …

Medicare Competitive Pricing: Lessons Being Learned In Phoenix And Kansas City, Nora Super

National Health Policy Forum

Written as policymakers scrutinized two Medicare competitive bidding demonstration projects set to take place in Phoenix and Kansas City, this issue brief analyzes two demonstration projects designed to test whether Medicare could pay health plans in a competitive manner. The brief reviews decisions made by the Competitive Pricing Advisory Commission (CPAC), including design considerations such as plan eligibility and participation, the standard benefit package, the bidding process, and the government contribution to premiums. It also looks at the reasons for opposition to the project and the relationship of this demonstration to broader efforts to reform the Medicare program.

The Public Stake In Biomedical Research: A Policy Perspective, Karen Matherlee

National Health Policy Forum

An introduction to a Forum series on biomedical research policy issues, this paper provides background on the organization and structure of both public and private research entities. It outlines the federal components, from the National Institutes of Health (NIH) to the Department of Veterans Affairs. It also looks at the rapid growth in pharmaceutical, biotechnology, and medical device research and development and the varying responses from managed care plans, practice-based research networks, and contract research organizations. After laying out various tensions in the field, such as competition among disease-oriented advocates, alignment of different priorities, allocation of dollars between basic and …

Is The Clean Air Act Unconstitutional?, Cass R. Sunstein

Michigan Law Review

This Article deals with two linked questions. The first involves the future of the Clean Air Act. The particular concern is how the Environmental Protection Agency ("EPA") might be encouraged, with help from reviewing courts, to issue better ambient air quality standards, and in the process to shift from some of the anachronisms of 1970s environmentalism to a more fruitful approach to environmental protection. The second question involves the role of the nondelegation doctrine in American public law, a doctrine that shows unmistakable signs of revival. I will suggest that improved performance by EPA and agencies in general, operating in …

Regulating Through Information: Disclosure Laws And American Health Care, William M. Sage

Faculty Scholarship

Efforts to reform the American health care system through direct government action have failed repeatedly. Nonetheless, an alternative strategy has emerged from these experiences: requiring insurance organizations and health care providers to disclose information to the public. In this Article, Professor Sage assesses the justifications for this type of regulation and its prospects. In particular, he identifies and analyzes four distinct rationales for disclosure. He finds that the most commonly articulated goal of mandatory disclosure laws-improving the efficiency of private purchasing decisions by giving purchasers complete information about price and quality- is the most complicated operationally. The other justifications-which he …

The Abcs Of Pbms, Robin J. Strongin

National Health Policy Forum

This issue brief describes the evolution of the pharmacy benefit manager (PBM) industry since the late 1960s and outlines current business practices in the areas of payment, services, drug formularies, and rebates. Tools of the trade, such as cost-sharing and generic substitution, used to control costs and improve quality are also discussed.

Chip And Medicaid Outreach And Enrollment: A Hands-On Look At Marketing And Applications, Judith D. Moore

National Health Policy Forum

The State Children's Health Insurance Program (SCHIP or CHIP), enacted as part of the Balanced Budget Act (BBA) in 1997, has enrolled eligible low-income children in innovative ways and tackled a variety of challenges to make sure that families know about the new program. This issue brief describes the outreach, application, and enrollment process for both SCHIP and Medicaid, analyzing the difficulty in simplifying applications, and noting problems that states must solve around systems design, immigration issues, and the stigma sometimes associated with government programs.

Site Visit To Baltimore And Fort Detrick, Maryland — Preparing For A Bioterrorist Incident: Linking The Public Health And Medical Communities, Robin J. Strongin

National Health Policy Forum

As follow-up to the NHPF's February 1999 session entitled "Biological Terrorism: Is the Health Care Community Prepared?" the Forum organized a site visit on October 4 and 5, 1999, to Baltimore and Fort Detrick, Maryland. The site visit provided federal congressional and agency staff with the opportunity to learn first-hand how one local area is preparing for the possibility of a bioterrorist incident. Several themes were stressed throughout the two days, including the following: distinguishing bioterrorism from chemical terrorism, understanding the relationships between various agencies and institutions and their related funding streams, determining how the federal government can …

Government As God: An Update On Federal Intervention In The Treatment Of Critically Ill Newborns, Dionne L. Koller

All Faculty Scholarship

Whether a severely impaired or critically ill infant should receive lifesaving, and sometimes extraordinary, medical treatment, or be allowed to die, is hotly debated. The issue initially garnered public attention in 1982, when an infant who was born with Down's Syndrome, “Baby Doe,” was allowed to die from a correctable birth defect. Following this, the federal government took a lead role in determining the fate of critically ill newborns. In the meantime, doctors, philosophers, and others have debated whether federal interference in this area is appropriate.

This essay will bring the reader up to date on the “Baby Doe” issue …

The Benefits Of Voluntary Inpatient Psychiatric Hospitalization: Myth Or Reality?, Donald H. Stone

All Faculty Scholarship

Throughout the United States, mentally ill persons are confined against their will in psychiatric hospitals as a result of being accused of dangerous behavior. Some are committed involuntarily by a judge after an administrative hearing during which they are afforded legal representation, a right to be present, and important due process protections, including the right to cross-examine witnesses and present one's own witnesses. However, a significant number of individuals, initially confined in psychiatric institutions for allegedly posing a danger to life or safety, never see an impartial judge, lawyer, or even a family member. These mentally ill individuals are not …

Mid-Atlantic Ethics Committee Newsletter, Fall-Winter 1999

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Looking For A Prince Among The Frogs: Solutions To Erisa's Preemptive Effect On Improving Health Care, Mk Gaedeke Roland

Buffalo Law Review

No abstract provided.

Genetic Privacy: There Ought To Be A Law, George J. Annas

Faculty Scholarship

If you don't believe in privacy, you probably don't believe in genetic privacy. I believe in privacy, including the constitutional right of privacy. But my interest is not to persuade you to believe in privacy, but rather to expose the major issues involved in genetic privacy. What makes genetic information different from other sensitive medical information? Are we getting carried away? Are we just treating DNA-based information differently because it is new?

Standards Of Care And Standard Form Contracts: Distinguishing Patient Rights And Consumer Rights In Managed Care, Wendy K. Mariner

Faculty Scholarship

There is hardly a legislature in the country that is not currently debating the issue of patient rights in managed care. Not surprisingly, legislators, as well as reporters covering the debate, have called upon George J. Annas, Edward R. Utley Professor of Health Law and Chair of the Health Law Department at Boston University, for information and advice. Professor Annas has earned the title of "father of patient rights" for his decades of research, writing, and advocacy on behalf of individuals who need health care and deserve justice.

Today, however, one might ask whether patient rights are compatible with managed …

Neither Science Nor Shamans: Globalization Of Markets And Health In The Developing World, David Fidler

Indiana Journal of Global Legal Studies

No abstract provided.

The Second Revolution In Informed Consent: Comparing Physicians To Each Other, Neil B. Cohen, Aaron D. Twerski

Faculty Scholarship

No abstract provided.

The Juvenile Rights Advocacy Project: Representing Girls In Context, Francine Sherman

Francine T. Sherman

No abstract provided.

A Chicken (Nugget?) In Every Pot: What's At Stake In The Budget Debate, Karl Polzer

National Health Policy Forum

This paper explores various aspects of the 1999 budget debate fueled in large part by federal agencies' projection of a $2.9 trillion surplus over 10 years. The tax bill, which would provide about $400 billion in tax relief, is also discussed; special attention is given to the health care provisions of this legislation.

The Nursing Center In Concept And Practice: Delivery And Financing Issues In Serving Vulnerable People, Karen Matherlee

National Health Policy Forum

This issue brief looks at ways in which nurse-managed centers — with support from the Health Resources and Services Administration and private foundations — are carving a role in providing preventive and primary care to vulnerable populations. Two case studies — one in Philadelphia and the other in the Utah-Nevada border area — llustrate nursing centers' mission, outreach, services, workforce, payment concerns, and educational tie-ins.

Dr. "Zorro" Leaves His Mark, Amy Nyitrai

Buffalo Women's Law Journal

No abstract provided.

A Troublesome Maternal-Fetal Conflict: Legal, Ethical, And Social Issues Surrounding Mandatory Azt Treatment Of Hiv Positive Pregnant Women, Jennifer Brown

Buffalo Public Interest Law Journal

No abstract provided.

Legalization Of The Birth Control Pill In Japan Will Reduce Reliance On Abortion As The Primary Method Of Birth Control, Evy F. Mcelmeel

Washington International Law Journal

The United Nations has decreed that access to a variety of methods of birth control is a basic human right, that prevention of pregnancy, not termination, is the goal of birth control, and that abortion is an unacceptable method of birth control. Until recently, condoms and the rhythm method were the only legal forms of contraception in Japan. The high failure rates of these methods, coupled with access to abortion on demand, made abortion the de facto primary method of birth control in Japan. The Japanese government's recent decision to end the ban on oral contraceptives will reduce the number …

Privacy In Genetics Research, Barbara Fuller, Mary Jo Ellis Kahn, P. A. Barr, L. Biesecker, E. Crowley, J. Garber, M. K. Mansoura, Patricia Murphy, J. Murray, J. Phillips, Karen H. Rothenberg, Mark Rothstein, J. Stopfer, Gary Swergold, B. Weber, Francis Collins, Kathy Hudson

Faculty Scholarship

No abstract provided.

California & The Hiv/Aids Epidemic: The State Of The State Report 1998, California Department Of Health Services

California Agencies

No abstract provided.

Mental Health Coverage Parity: Separating Wheat From Chaff, Karl Polzer

National Health Policy Forum

This paper examines the issue of mandating parity in coverage of mental health services in the context of the growing use by private-sector employers of managed behavioral health care providers. Existing parity laws are reviewed, along with estimates of the costs of parity. The tools used by behavioral health care firms to manage care and costs are also discussed.

Access To Home Health Services Under Medicare's Interim Payment System, Nora Super

National Health Policy Forum

This issue brief explores the impact of the interim payment system (IPS) for home health agencies established under the Balanced Budget Act of 1997 (BBA). IPS was intended to constrain program outlays by imposing limits on spending per beneficiary and spending per visit in the existing cost-based reimbursement system. This issue brief examines the impact of the IPS on access to home health care, including home health agencies' responses to the payment system and its impact on provider availability and, ultimately, access to care for the sickest or most expensive populations

Implementing The Bba: The Challenge Of Moving Medicare Post-Acute Services To Pps, Karen Matherlee

National Health Policy Forum

This issue brief examines the challenge of putting skilled nursing facilities (SNFs), medical rehabilitation units, and home health under prospective payment, requiring the development of classification systems for each. It looks at the three-year phase-in of SNF resource utilization groups (RUGs) that began July 1, 1998 and the debate over classification systems for medical rehabilitation facilities and home health. The paper goes beyond issues of classification to consider coordination problems in placing these post-acute services under Medicare PPS.