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Articles 1 - 30 of 95
Full-Text Articles in Law
The Federal-State Medicaid Match: An Ongoing Tug-Of-War Over Practice And Policy, Karen Matherlee
The Federal-State Medicaid Match: An Ongoing Tug-Of-War Over Practice And Policy, Karen Matherlee
National Health Policy Forum
Reviewing Medicaid match issues since the latter 1980s, this issue brief traces ways in which some states have used creative financing to get more Medicaid matching dollars than they otherwise would qualify for from the federal government. It explores the latest mechanism, states' use of so-called intergovernmental transfers of funds (to avoid established upper payment limits) to increase their matches, triggering efforts by the Senate Finance Committee and the federal Medicaid agency to ban such transfers.
Caring For The Elderly: Oregon's Pioneers (Portland, Oregon), Nora Super, Lisa Sprague
Caring For The Elderly: Oregon's Pioneers (Portland, Oregon), Nora Super, Lisa Sprague
National Health Policy Forum
This site visit looked at the continuum of care for its elderly and disabled citizens in the first state ever to secure Section 1915(c) and (d) waivers under Medicaid to support home- and community-based services. More than three-quarters of Oregon's Medicaid clients now receive care in these settings. Site visitors were briefed on the history and development of long-term care in the state as well as the various care settings available. Panels discussed strategies and partnerships focused on alleviating workforce shortages and highlighted Oregon nurses' authority to delegate certain caregiving tasks to laypeople. Multnomah County staff described county-level activities, especially …
Emerging Issues In The Use Of Binding Arbitration To Resolve Disputes Between Individuals And Health Plans, Karl Polzer
Emerging Issues In The Use Of Binding Arbitration To Resolve Disputes Between Individuals And Health Plans, Karl Polzer
National Health Policy Forum
After briefly describing the federal legal framework fostering the growth of binding arbitration, this paper identifies controversies surrounding arbitration as well as arguments supporting and opposing its use. The paper describes the use of arbitration among certain types of collectively bargained employee health plans regulated under the Employee Retirement Income Security Act of 1974 (ERISA), by health maintenance organizations (HMOs) in California, and by a large employer operating a self-insured ERISA health plan. Evidence cited by the California Supreme Court that the largest HMO in California operated its mandatory arbitration program in an unfair way is presented, along with the …
The Integrity Of Death: Resolving Dilemmas In Medicine, Larry I. Palmer
The Integrity Of Death: Resolving Dilemmas In Medicine, Larry I. Palmer
Faculty Publications
No abstract provided.
Mid-Atlantic Ethics Committee Newsletter, Fall-Winter 2000
Mid-Atlantic Ethics Committee Newsletter, Fall-Winter 2000
Mid-Atlantic Ethics Committee Newsletter
No abstract provided.
Understanding Medicaid Home And Community Services: A Primer, Gary Smith, Janet O'Keeffe, Letty Carpenter, Pamela Doty, Brian Burnwell, Robert Mollica, Loretta Williams, George Washington University, Center For Health Policy Research
Understanding Medicaid Home And Community Services: A Primer, Gary Smith, Janet O'Keeffe, Letty Carpenter, Pamela Doty, Brian Burnwell, Robert Mollica, Loretta Williams, George Washington University, Center For Health Policy Research
Center for Health Policy Research
No abstract provided.
Schip In The Formative Years: An Update, Judith D. Moore
Schip In The Formative Years: An Update, Judith D. Moore
National Health Policy Forum
This issue brief examines the status of the State Children's Health Insurance Program (SCHIP) three years after authorizing legislation was enacted. Topics addressed include enrollment and retention of children in new programs, funding allotments and expenditures, evaluation activities planned and underway, the interaction of Medicaid and SCHIP, and problems common across many states.
Medicare+Choice: Where To From Here?, Nora Super
Medicare+Choice: Where To From Here?, Nora Super
National Health Policy Forum
This issue brief examines Medicare+Choice (M+C) plan participation, benefit coverage, and enrollment and the factors that have contributed to plans' decisions to participate in or withdraw from certain markets. In addition, the issue brief explores what has been happening to M+C enrollees in terms of costs, benefits, and continuity of care. Lastly, the issue brief examines the reasons that alternative plan options — such as preferred provider organizations (PPOs) and provider-sponsored organizations (PSOs) — have not taken hold. Legislative proposals that might affect the future of M+C are also discussed.
Section 1: Ferguson V. City Of Charleston, Institute Of Bill Of Rights Law, William & Mary Law School
Section 1: Ferguson V. City Of Charleston, Institute Of Bill Of Rights Law, William & Mary Law School
Supreme Court Preview
No abstract provided.
The Asthma Epidemic: Prospects For Controlling An Escalating Public Health Crisis, Richard Hegner
The Asthma Epidemic: Prospects For Controlling An Escalating Public Health Crisis, Richard Hegner
National Health Policy Forum
This background paper examines the dimensions of the recent asthma epidemic and what could be done to contain it. Information about the prevalence and consequences of asthma across demographic groups is presented. Factors that impede the control of asthma are also identified. The paper also examines the possible causes of asthma and the asthma epidemic as well as new theories about the relationship of asthma to overall advances in health care and economic development. It also discusses the economic implications of asthma and possible cost avoidances linked to better asthma management. The paper concludes with discussions of asthma and public …
Insuring Virginia's Children: Local Outreach And Enrollment (Northern Virginia), Lisa Sprague, Judith D. Moore
Insuring Virginia's Children: Local Outreach And Enrollment (Northern Virginia), Lisa Sprague, Judith D. Moore
National Health Policy Forum
This one-day visit to a nearby jurisdiction was designed to allow participation by federal staff who have been unable to commit the three days required by a typical Forum site visit. Site visitors were given an overview of health care in Virginia and an introduction to the Children's Medical Income Security Program (CMSIP) as well as its proposed replacement, the Family Access to Medical Insurance Security program (FAMIS). A panel representing community organizations and providers shared their experience, touching on provider concerns, coordination of outreach efforts across counties, and assistance for clients after they are enrolled. The group visited the …
Outpatient Commitment In Mental Health: Is Coercion The Price Of Community Services?, Coimbra Sirica
Outpatient Commitment In Mental Health: Is Coercion The Price Of Community Services?, Coimbra Sirica
National Health Policy Forum
This paper reviews the debate over civil commitment to outpatient settings of people with mental illness who are considered too ill and/or too dangerous to be left on their own in their communities. The choices of two states — Maryland and New York — in dealing with this issue are reviewed. Alternative ways of drawing people into treatment and keeping them there are also discussed.
Mid-Atlantic Ethics Committee Newsletter, Summer 2000
Mid-Atlantic Ethics Committee Newsletter, Summer 2000
Mid-Atlantic Ethics Committee Newsletter
No abstract provided.
California & The Hiv/Aids Epidemic: The State Of The State Report 1999, California Department Of Health Services
California & The Hiv/Aids Epidemic: The State Of The State Report 1999, California Department Of Health Services
California Agencies
No abstract provided.
Optional Purchasing Specifications For Child Development Services In Medicaid Managed Care, George Washington University Medical Center, Center For Health Services Research And Policy
Optional Purchasing Specifications For Child Development Services In Medicaid Managed Care, George Washington University Medical Center, Center For Health Services Research And Policy
Center for Health Policy Research
These sample purchasing specifications were prepared by the George Washington University Center for Health Services Research and Policy (CHSRP) with support from the Commonwealth Fund. Technical guidance on the content of child development services was provided by experts from the Fund and researchers at Northwestern University’s Institute for Health Services Research & Policy Studies (IHSRPS). This document is intended as a tool to assist interested state officials in purchasing child development services from managed care organizations (MCOs) on behalf of children under age three who are eligible for Medicaid.
These sample purchasing specifications are optional, and do not necessarily reflect …
Beyond Stigma: What Barriers Actually Affect The Decisions Of Low-Income Families To Enroll In Medicaid?, Jennifer P. Stuber, Kathleen A. Maloy, Sara Rosenbaum, Karen C. Jones
Beyond Stigma: What Barriers Actually Affect The Decisions Of Low-Income Families To Enroll In Medicaid?, Jennifer P. Stuber, Kathleen A. Maloy, Sara Rosenbaum, Karen C. Jones
Health Policy and Management Issue Briefs
No abstract provided.
The Best-Laid Plans, Carl E. Schneider
The Best-Laid Plans, Carl E. Schneider
Articles
It is natural to suppose law is like the centurion and can do as it will: "I say to this man, Go, and he goeth; and to another, Come, and he cometh; and to my servant, Do this, and he doeth it." But a thousand years ago, King Canute tried to disillusion his courtiers about his efficacy by commanding the waves to stop beating. And fifty years ago, Harry Truman predicted of Dwight Eisenhower, "He'll sit here, and he'll say, 'Do this! Do that!' And nothing will happen. Poor Ike-it won't be a bit like the Army. He'll find it …
Hcfa's Outpatient Pps: Finally Ready To Roll?, Karen Matherlee
Hcfa's Outpatient Pps: Finally Ready To Roll?, Karen Matherlee
National Health Policy Forum
This issue brief centers on hospital outpatient department services, scheduled to be on a prospective payment system (PPS) July 1, 2000, 17 years after enactment of legislation mandating PPS for hospital inpatient services. It looks at the challenges to providers and patients, including coding and other process issues, redistribution of payments, and changes in beneficiary co-payments.
Using Schip To Subsidize Employment-Based Coverage: How Far Can This Strategy Go?, Karl Polzer
Using Schip To Subsidize Employment-Based Coverage: How Far Can This Strategy Go?, Karl Polzer
National Health Policy Forum
This background paper examines and analyzes early efforts by states to subsidize employment-based health insurance under the State Children's Health Insurance Program (SCHIP), which offers states a more generous funding rate than under Medicaid. As the Health Care Financing Administration prepares to issue regulations governing SCHIP, the paper summarizes complaints by state officials that federal rules governing how job-based coverage might be subsidized under the program are overly complex and rigid. After interviewing officials at the federal level and in six states as well as a variety of researchers and policy experts, the author considered whether and to what extent …
Prevalence And Risk Factors For Potentially Avoidable Hospitalization Of Medicaid-Enrolled Assisted Living Residents, Marion Becker, Timothy Boaz, Ross Andel, Joshua Digennaro
Prevalence And Risk Factors For Potentially Avoidable Hospitalization Of Medicaid-Enrolled Assisted Living Residents, Marion Becker, Timothy Boaz, Ross Andel, Joshua Digennaro
Mental Health Law & Policy Faculty Publications
No abstract provided.
Regulating Research With Decisionally Impaired Individuals: Are We Making Progress?, Diane E. Hoffmann, Jack Schwartz, Evan G. Derenzo
Regulating Research With Decisionally Impaired Individuals: Are We Making Progress?, Diane E. Hoffmann, Jack Schwartz, Evan G. Derenzo
Faculty Scholarship
No abstract provided.
Pharmaceutical Marketplace Dynamics, Robin J. Strongin
Pharmaceutical Marketplace Dynamics, Robin J. Strongin
National Health Policy Forum
This issue brief provides a profile of the pharmaceutical industry and explores topics such as competition, generics, intellectual property, research and development, pricing, and distribution. It also discusses government programs such as the Department of Veterans' Affairs federal supply schedule and Medicaid rebates.
Reinventing Medicaid: Hoosier Healthwise And Children's Health Insurance In Indiana, Judith D. Moore, Lisa Sprague
Reinventing Medicaid: Hoosier Healthwise And Children's Health Insurance In Indiana, Judith D. Moore, Lisa Sprague
National Health Policy Forum
This site visit explored the factors that have made Indiana so successful in enrolling children in its Medicaid and SCHIP plans under the brand name Hoosier Healthwise. Site visitors met with legislators and state officials to gain understanding of the genesis and development of Hoosier Healthwise and its aggressive outreach component. A panel of representatives from partner organizations engaged in enrolling children provided further insight into this process. The site visit participants traveled to observe enrollment and operations in both urban (Marion) and rural (Clay) county offices. They also met with health care executives at hospitals, clinics, and neighborhood health …
Dispelling The Myths And Stigma Of Mental Illness: The Surgeon General's Report On Mental Health, Richard Hegner
Dispelling The Myths And Stigma Of Mental Illness: The Surgeon General's Report On Mental Health, Richard Hegner
National Health Policy Forum
This paper summarizes the key findings of "Mental Health: A Report of the Surgeon General," which was released on December 13, 1999, by U.S. Surgeon General David Satcher. Topics include the significance of mental illness, the effectiveness of diagnosis and treatment, the widespread lack of treatment, access problems and their causes, the significance of stigma, and the prevention of mental illness.
Site Visit To Seattle — University Of Washington Academic Medical Center, Karen Matherlee
Site Visit To Seattle — University Of Washington Academic Medical Center, Karen Matherlee
National Health Policy Forum
The event was part of a series of three site visits leading to an April 27–28, 2000, conference in Annapolis, Maryland, on hospital-based health care systems in transition after enactment of the Balanced Budget Act of 1997 (BBA) and the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA). The site visit focused on the challenges the University of Washington (UW) faces in carrying out its three missions of delivery of health services (with emphasis on the safety net), health professions education, and health science and clinical research. It probed the effects of the BBA on these missions …
Mid-Atlantic Ethics Committee Newsletter, Spring 2000
Mid-Atlantic Ethics Committee Newsletter, Spring 2000
Mid-Atlantic Ethics Committee Newsletter
No abstract provided.
Applying Science To Public Policy: The Context Of The Surgeon General's Report On Mental Health, Richard Hegner
Applying Science To Public Policy: The Context Of The Surgeon General's Report On Mental Health, Richard Hegner
National Health Policy Forum
Intended to provide public policy context for the December 1999 Surgeon General's Report on Mental Health, this background paper discusses the historic skepticism about the efficacy of treatment of mental illness in this country, insurance practices that have discriminated against mental illness and the reasons for them, the disproportionate share of mental health funding provided by government sources such as Medicaid and state general revenues, the role of state and local public government as providers of catastrophic coverage for mental illness, the cascading cost-shifting game in mental health finance, obstacles to needed treatment (including popular attitudes toward mental illness), the …
Pulliam V. Coastal Emergency Services Of Richmond, Inc.: Reconsidering The Standard Of Review And Constitutionality Of Virginia's Medical Malpractice, Elizabeth Keith
Pulliam V. Coastal Emergency Services Of Richmond, Inc.: Reconsidering The Standard Of Review And Constitutionality Of Virginia's Medical Malpractice, Elizabeth Keith
Articles in Law Reviews & Other Academic Journals
Consider the following scenario. A plaintiff is injured in a devastating automobile accident and a jury finds the other driver negligent. As a result of that driver's negligence, the plaintiff is now a quadriplegic. The jury, after careful deliberation and calculation, awards $4.5 million to the plaintiff consisting of both economic damages for past and future medical expenses, as well as non-economic damages for pain and suffering and loss of enjoyment of life. Now consider a similar scenario. The plaintiff is a patient who is injured during a low-risk surgical procedure and a jury finds the surgeon negligent. As a …
Nursing Home Residents And The New California Health Care Decisions Law, David M. English, Rebecca C. Morgan
Nursing Home Residents And The New California Health Care Decisions Law, David M. English, Rebecca C. Morgan
Faculty Publications
This article explores issues involving advance directives made by nursing home residents, both prior to and during their stay in a facility, including the frequency of making directives, the reasons why residents fail to make directives, and the reasons why facilities often fail to honor them. Specifically, this article examines these issues in light of the 1999 California Health Care Decisions Law, effective July 1, 2000, and focuses on how this new statute can be used to empower nursing home residents, and adults more generally, to take control of decisions regarding their own health care.
Site Visit To Detroit — Henry Ford Health System, Lisa Sprague
Site Visit To Detroit — Henry Ford Health System, Lisa Sprague
National Health Policy Forum
This event was one in a series of three site visits leading to an April 27–28, 2000, conference in Annapolis, Maryland, on hospital-based health care systems in transition after the enactment of the Balanced Budget Act of 1997 (BBA) and the Medicare, Medicaid, SCHIP Balanced Budget Refinement Act of 1999 (BBRA). The site visit explored the responses of a large integrated system, the Henry Ford Health System, to the BBA and how the BBA has interacted with other changes in the system's local market and state Medicaid program. Panel presentations highlighted financing and information systems, the integration of diversified services, …