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Articles 1 - 19 of 19
Full-Text Articles in Law
The Patient's Voice: Legal Implications Of Patient-Reported Outcome Measures, Sharona Hoffman, Andy Podgurski
The Patient's Voice: Legal Implications Of Patient-Reported Outcome Measures, Sharona Hoffman, Andy Podgurski
Faculty Publications
In recent years, the medical community has paid increasing attention to patients' own assessments of their health status. Even regulatory agencies, such as the Food and Drug Administration and the Centers for Medicare and Medicaid Services, are now interested in patient self-reports. The legal implications of this shift, however, have received little attention. This Article begins to fill that gap. It introduces to the legal literature a discussion that has been ongoing in the health care field.
Patient-reported outcome measures (PROMs) are reports of patients’ symptoms, treatment outcomes, and health status that are documented directly by patients, typically through electronic …
Specialty Drugs And The Health Care Cost Crisis, Sharona Hoffman, Isaac D. Buck
Specialty Drugs And The Health Care Cost Crisis, Sharona Hoffman, Isaac D. Buck
Faculty Publications
Specialty drugs, often dispensed by specialty pharmacies, are among the most expensive drugs on the market. They are significant contributors to the American health care cost problem, but in many ways they escape public and regulatory scrutiny. Surprisingly, medications are designated as specialty drugs by pharmacy benefit managers (PBMs), entities that are part of the insurance industry, rather than by the Food and Drug Administration or medical authorities.
Specialty drugs have thus far received little attention in the legal literature. Yet, they raise important legal and regulatory questions. For example, there are no federal government rules (and only a handful …
The Burden Of A Good Idea: Examining The Impact Of Unfunded Federal Regulatory Mandates On Medicare Participating Hospitals, Rachel Juhas Suddarth
The Burden Of A Good Idea: Examining The Impact Of Unfunded Federal Regulatory Mandates On Medicare Participating Hospitals, Rachel Juhas Suddarth
Law Faculty Publications
Health care costs are on the rise. In 1960, the United States spent $9 billion on hospital care. Since then, hospital related spending has grown exponentially. In 2015, the United States spent over $1 trillion on hospital care, with $359.9 billion of those payments coming from the federal Medicare program for the aged and disabled. Researchers have long tried to understand the exact causes of rising health care costs. While many have closely examined the costs associated with population demographics, medical innovation, prescription drug costs, overutilization of services, and fraud or abuse, there is one driving force that does not …
It Saves To Be Healthy: Using The Tax Code To Incentivize Employer-Provided Wellness Benefits, Hilary R. Shepherd
It Saves To Be Healthy: Using The Tax Code To Incentivize Employer-Provided Wellness Benefits, Hilary R. Shepherd
Indiana Law Journal
With lifestyle-related disease on the rise and an increasing number of employers being held responsible for providing health insurance to their employees, we as a society have incentives to promote wellness, even if only to cut health care costs. Part I of this Note outlines a brief history of employer-provided wellness benefits and provides a concise summary of the employer-provided wellness benefits available. Part II analyzes the relevant federal income tax law, specifically, the fringe benefits provision of the Internal Revenue Code, and concludes that under existing tax law, on-premises gym facilities do not yield any taxable income to employees, …
The Double-Edged Sword Of Health Care Integration: Consolidation And Cost Control, Erin C. Fuse Brown, Jaime S. King
The Double-Edged Sword Of Health Care Integration: Consolidation And Cost Control, Erin C. Fuse Brown, Jaime S. King
Indiana Law Journal
The average family of four in the United States spends $25,826 per year on health care. American health care costs so much because we both overuse and overpay for health care goods and services. The Affordable Care Act’s cost control policies focus on curbing overutilization by encouraging health care providers to integrate to pro-mote efficiency and eliminate waste, but the cost control policies largely ignore prices. This article examines this overlooked half of health care cost control policy: rising prices and the policy levers held by the states to address them. We challenge the conventional wisdom that reducing overutilization through …
A Defense Of Physicians’ Gatekeeping Role: Balancing Patients’ Needs With Society’S Interests, Jessica Mantel
A Defense Of Physicians’ Gatekeeping Role: Balancing Patients’ Needs With Society’S Interests, Jessica Mantel
Pepperdine Law Review
Although scholars and policymakers increasingly accept the need to ration health care, physicians doing so at the bedside remains controversial. Underling this debate is how to characterize the duty of care physicians owe their individual patients. Ethically, physicians are under strict fiduciary obligations that require them to give primacy to individual patients' best interests. However, new health care delivery models that hold providers financially accountable for health care costs assign to physicians a gatekeeping role, with physicians obliged to balance individual patients' needs with the competing societal goal of controlling costs. This Article explains that the choice between the traditional …
Managed Care Grievance Procedures: The Dilemma And The Cure , Joyce Krutick Craig
Managed Care Grievance Procedures: The Dilemma And The Cure , Joyce Krutick Craig
Journal of the National Association of Administrative Law Judiciary
No abstract provided.
Family Caregiving And The Law Of Succession: A Proposal, Thomas P. Gallanis, Josephine Gittler
Family Caregiving And The Law Of Succession: A Proposal, Thomas P. Gallanis, Josephine Gittler
University of Michigan Journal of Law Reform
As the American population ages, the need for long-term care, already great, will become even greater. Some of this care is paid for by government programs, such as Medicaid, and by individual long-term care insurance policies. But the combination of the public fisc and private insurance are, and will continue to be, insufficient to pay for all of the care our seniors and adults with disabilities need. The provision of care in a family residence by one or more family members is an important component of our health care delivery system and must be supported and encouraged by public policy …
The Drugs Stop Here: A Public Health Framework To Address The Drug Shortage Crisis, Sharona Hoffman
The Drugs Stop Here: A Public Health Framework To Address The Drug Shortage Crisis, Sharona Hoffman
Faculty Publications
Drug shortages are emerging as a major public health threat. Grave concern has been expressed by the medical community and government officials, and the crisis has been highlighted in recent media stories. Nevertheless, little has been written to date in the legal literature about the drug shortage crisis, and this timely article begins to fill this gap. It provides a thorough analysis of the origins and implications of the drug shortage problem and formulates a multi-layered approach to addressing it. The article argues that drug shortages result from a combination of market failures and regulatory constraints. It proposes a blend …
Further Support For Mental Health Parity Law And Mandatory Mental Health And Substance Use Disorder Benefits, Stacey A. Tovino
Further Support For Mental Health Parity Law And Mandatory Mental Health And Substance Use Disorder Benefits, Stacey A. Tovino
Scholarly Works
In this Article, I provide additional support for my recent proposal* to extend federal mental health parity law and mandatory mental health and substance use disorder benefits to all public healthcare program beneficiaries and private health plan members. I begin by examining health-related doctrine outside the context of mental health insurance law, including disability discrimination law, civil rights and human rights law, health information confidentiality law, healthcare reform law, and child and adult health and welfare law, and I find that not one of these laws provides inferior legal protections or benefits for individuals with mental illness. I also analyze …
The Pragmatist’S Guide To Comparative Effectiveness Research, Amitabh Chandra, Anupam B. Jena, Jonathan Skinner
The Pragmatist’S Guide To Comparative Effectiveness Research, Amitabh Chandra, Anupam B. Jena, Jonathan Skinner
Dartmouth Scholarship
No abstract provided.
Improving Health Care Outcomes Through Personalized Comparisons Of Treatment Effectiveness Based On Electronic Health Records, Sharona Hoffman, Andy Podgurski
Improving Health Care Outcomes Through Personalized Comparisons Of Treatment Effectiveness Based On Electronic Health Records, Sharona Hoffman, Andy Podgurski
Faculty Publications
Comparative effectiveness research (CER) is one of the Patient Protection and Affordable Care Act’s significant initiatives that aims to improve treatment outcomes and lower health care costs. This Article takes CER a step further and suggests a novel clinical application for it. The Article proposes the development of a national framework to enable physicians to rapidly perform, through a computerized service, medically sound personalized comparisons of the effectiveness of possible treatments for patients’ conditions. A treatment comparison for a given patient would be based on data from electronic health records of a cohort of clinically similar patients who received the …
What If Technology Never Stops Improving? Medicare's Future Under Continuous Cost Increases, Mark V. Pauly
What If Technology Never Stops Improving? Medicare's Future Under Continuous Cost Increases, Mark V. Pauly
Washington and Lee Law Review
No abstract provided.
Trust And Betrayal In The Medical Marketplace, Maxwell Gregg Bloche
Trust And Betrayal In The Medical Marketplace, Maxwell Gregg Bloche
Georgetown Law Faculty Publications and Other Works
The author argues in this Comment that disingenuity as first resort is an unwise approach to the conflict between our ex ante and our later, illness-endangered selves. Not only does rationing by tacit deceit raise a host of moral problems, it will not work, over the long haul, because markets reward deceit's unmasking. The honesty about clinical limit-setting that some bioethicists urge may not be fully within our reach. But more candor is possible than we now achieve, and the more conscious we are about decisions to impose limits, the more inclined we will be to accept them without experiencing …
You Get What You Pay For: Result-Based Compensation For Health Care, David A. Hyman, Charles Silver
You Get What You Pay For: Result-Based Compensation For Health Care, David A. Hyman, Charles Silver
Washington and Lee Law Review
No abstract provided.
Exploitation Of The Elite: A Case For Physician Unionization, Dionne L. Koller
Exploitation Of The Elite: A Case For Physician Unionization, Dionne L. Koller
All Faculty Scholarship
Our intuition tells us that physicians are elites, and therefore they cannot be exploited. Relying on this intuition, we adopt policies which attempt to provide a health care system that gives first-quality care, at the lowest prices, delivered through a “free-market” system. As the key gatekeepers to health care, physicians are thus caught in the middle. Top-notch American health care costs money and for-profit MCOs must watch their bottom line. Rationing, therefore, is key. The issue is, assuming we have decided that free-market health care is the solution, how much should physicians have to sacrifice in the name of the …
Resolving Conflicting Laws And Policy In Integrated Delivery Systems Development, Anthony D. Shaffer, Peter A. Pavarini
Resolving Conflicting Laws And Policy In Integrated Delivery Systems Development, Anthony D. Shaffer, Peter A. Pavarini
Journal of Law and Health
Health care legal advisors are often called on to rationalize and synthesize these conflicting laws and policies while assisting clients to meet current market demands in developing competitive integrated delivery systems ("IDS"). This article explores the myriad of laws and regulations that affect integrated delivery systems development and proposes a practical approach for reconciling conflicting laws and policies. Some legal practitioners may recognize the proposed method as the process they already follow. For others, the suggestions in this article will hopefully challenge them to see conflicts of law and policy as opportunities to engage in creative thinking.
Legal Issues In The Healthcare Settings Aids: Current State Of The Law - An Overview, Carol A. Mclaughlin
Legal Issues In The Healthcare Settings Aids: Current State Of The Law - An Overview, Carol A. Mclaughlin
Journal of Law and Health
Presented as part of an address on the current state of the law at the AIDS Symposium held at Cleveland-Marshall College of Law on March 11, 1988.
Annotated Bibliography On Aids, Edmund F. Santa Vicca
Annotated Bibliography On Aids, Edmund F. Santa Vicca
Journal of Law and Health
This bibliography was included in the AIDS Symposium held at Cleveland-Marshall College of Law on March 11, 1988 as a helpful reference guide. The Journal would like to thank Edmund Santa Vicca for his ever continuing support in the quest for knowledge.