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The Most Important Health Care Legislation Of The Millennium (So Far): The Medicare Modernization Act, Timothy Stoltzfus Jost
The Most Important Health Care Legislation Of The Millennium (So Far): The Medicare Modernization Act, Timothy Stoltzfus Jost
Timothy S. Jost
Whether or not one believes that the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) in fact improves or modernizes Medicare, the legislation obviously changes the program radically. The extent and nature of these changes make the MMA the most important piece of health care legislation to be adopted by Congress to date in this young millennium. The MMA also contains what are arguably the most important amendments to the Medicare program since its creation. This Essay first describes the identifying characteristics of the current Medicare program, then examines the significant changes that the MMA makes in the program, and …
Pharmaceutical Research And Manufacturers Of America V. Walsh: The Supreme Court Allows The States To Proceed With Expanding Access To Drugs, Timothy Stoltzfus Jost
Pharmaceutical Research And Manufacturers Of America V. Walsh: The Supreme Court Allows The States To Proceed With Expanding Access To Drugs, Timothy Stoltzfus Jost
Timothy S. Jost
On May 19, 2003, the Supreme Court in Pharmaceutical Research and Manufacturers of America v. Walsh affirmed a court of appeals decision allowing for the implementation of the Maine Act to Establish Fairer Pricing for Prescription Drugs.' The Maine program attempted to leverage the considerable market power of the Medicaid program to force drug companies to offer the state a discount on pharmaceuticals. The state in turn would pass the savings on to its uninsured residents. Manufacturers that refused to negotiate a discount with the state would face the prospect of their products being available to Maine Medicaid recipients only …
The Independent Medicare Advisory Board, Timothy Stoltzfus Jost
The Independent Medicare Advisory Board, Timothy Stoltzfus Jost
Timothy S. Jost
It is a common realization that neither unconstrained markets nor our current political institutions are capable of governing our health care system. The cost of health care is spinning dangerously out of control, yet market forces alone cannot manage these costs because of a host of relatively well-understood market failures. Moreover, our traditional political institutions - Congress and the executive administrative agencies - have also failed us in this respect. These institutions are too driven by special interest politics and too limited in their expertise and vision to control costs. Both Medicare payment formulas and coverage determinations often seem to …
Pegram V. Herdrich: The Supreme Court Confronts Managed Care, Timothy S. Jost
Pegram V. Herdrich: The Supreme Court Confronts Managed Care, Timothy S. Jost
Timothy S. Jost
ERISA, adopted a quarter century ago to reform private pension law, imposed by the end of the twentieth century a seemingly insurmountable barrier to managed care reform. The Supreme Court's decision in Pegram v. Herdrich blocked one path out of the ERISA morass-broader use of breach of ERISA fiduciary obligations suits in federal court. On the other hand, it opened another path to holding HMOs accountable in malpractice cases in state court-and suggested that ERISA might impose fiduciary obligations to disclose incentives on HMOs. It is therefore an important decision. ERISA was intended to give the federal government primary authority …