Law Commons^™

What Congress's Repeal Efforts Can Teach Us About Regulatory Reform, Cary Coglianese, Gabriel Scheffler

All Faculty Scholarship

Major legislative actions during the early part of the 115th Congress have undermined the central argument for regulatory reform measures such as the REINS Act, a bill that would require congressional approval of all new major regulations. Proponents of the REINS Act argue that it would make the federal regulatory system more democratic by shifting responsibility for regulatory decisions away from unelected bureaucrats and toward the people’s representatives in Congress. But separate legislative actions in the opening of the 115th Congress only call this argument into question. Congress’s most significant initiatives during this period — its derailed attempts to repeal …

Partitioning Sorted Sets: Overcoming Choice Overload While Maintaining Decision Quality, Benedict C.G. Dellaert, Tom Baker, Eric J. Johnson

All Faculty Scholarship

We investigate the joint use of partitioning and sorting as a choice architecture to overcome consumer choice overload in large product sets. Partitioning first presents a small initial set of alternatives with the option to click through to see the remaining alternatives. Sorting presents alternatives in order of attractiveness based on a user model that is helpful to the decision-maker. We propose that Sets with Partitioning and Sorting (SPSs) improve consumers’ choice outcomes by increasing their focus on the most attractive alternatives and their use of more compensatory decisions. Results from two controlled survey-based experiments and a field study in …

Risk And Resilience In Health Data Infrastructure, W. Nicholson Price Ii

Articles

Today’s health system runs on data. However, for a system that generates and requires so much data, the health care system is surprisingly bad at maintaining, connecting, and using those data. In the easy cases of coordinated care and stationary patients, the system works—sometimes. But when care is fragmented, fragmented data often result. Fragmented data create risks both to individual patients and to the system. For patients, fragmentation creates risks in care based on incomplete or incorrect information, and may also lead to privacy risks from a patched together system. For the system, data fragmentation hinders efforts to improve efficiency …

Artificial Intelligence In Health Care: Applications And Legal Implications, W. Nicholson Price Ii

Articles

Artificial intelligence (AI) is rapidly moving to change the healthcare system. Driven by the juxtaposition of big data and powerful machine learning techniques—terms I will explain momentarily—innovators have begun to develop tools to improve the process of clinical care, to advance medical research, and to improve efficiency. These tools rely on algorithms, programs created from healthcare data that can make predictions or recommendations. However, the algorithms themselves are often too complex for their reasoning to be understood or even stated explicitly. Such algorithms may be best described as “black-box.” This article briefly describes the concept of AI in medicine, including …

Healthcare And Its Impact On Nurses: The United States Vs. The United Kingdom, Alexandria Colovos

Mahurin Honors College Capstone Experience/Thesis Projects

Currently, in the United States, the topic of healthcare reform is in the back of everyone’s mind. What will come of our healthcare system? Will the cost of healthcare decrease? Will patients have better access to care? With this Capstone Experience/Thesis, I wanted to explore the differences between the current healthcare system that we have in the United States, to the nearly seventy-year-old National Health Service (NHS) in the United Kingdom, which provides healthcare to all. The NHS is free at the point of care and is funded by taxation. To understand if such a system would work in the …

Rethinking The Americans With Disabilities Act’S Insurance Safe Harbor, Valarie K. Blake

Law Faculty Scholarship

Despite the importance of access to healthcare for the disabled, the Americans with Disabilities Act (ADA) has made little inroads in reducing disability-based discrimination by health insurers in the United States. One reason is undoubtedly the ADA’s insurance safe harbor, which explicitly permits insurers to discriminate on the basis of disability in health insurance so long as the differential treatment is supported by actuarial data and is not just intended to disadvantage the disabled. While the safe harbor’s harms are somewhat limited by the advent of the Affordable Care Act (ACA), they are not entirely neutralized. This article argues that …

Law Library Blog (November 2017): Legal Beagle's Blog Archive, Roger Williams University School Of Law

Law Library Newsletters/Blog

No abstract provided.

Prisoners With Disabilities, Margo Schlanger

Book Chapters

A majority of American prisoners have at least one disability. So how jails and prisons deal with those prisoners’ needs is central to institutional safety and humaneness, and to reentry success or failure. In this chapter, I explain what current law requires of prison and jail officials, focusing on statutory and constitutional law mandating non-discrimination, accommodation, integration, and treatment. Jails and prisons have been very slow to learn the most general lesson of these strictures, which is that officials must individualize their assessment of and response to prisoners with disabilities. In addition, I look past current law to additional policies …

Szymborski V. Spring Mtn. Treatment Ctr., 133 Nev. Adv. Op. 80 (Oct. 26, 2017), Paloma Guerrero

Nevada Supreme Court Summaries

The Court determined medical malpractice, and subsequent adherence to NRS 41A.071, involves a medical diagnosis, treatment, or judgment, and when the standards of care pertaining to the medical issue require explanation to the jury from a medical expert at trial. Therefore, Szymborski’s claims for negligence, malpractice, gross negligence, negligence per se, and negligent hiring, training, and supervision state claims for relief which were not based on a medical treatment or judgment and should not have been dismissed for failure to attach the NRS 41A.071 affidavit.

Systems-Based Training In Graduate Medical Education For Service Learning In The State Legislature In The United States: Pilot Study, Shikhar H. Shah, Maureen D. Clark, Kimberly Hu, Jalene A. Shoener, Joshua Fogel, William C. King, James Ronayne

Publications and Research

Background: There is a dearth of advocacy training in graduate medical education in the United States. To address this void,the Legislative Education and Advocacy Development (LEAD) course was developed as an interprofessional experience, partnering a cohort of pediatrics residents, fourth-year medical students, and public health students to be trained in evidence-informed health policy making.

Objective: The objective of our study was to evaluate the usefulness and acceptability of a service-based legislative advocacy course.

Methods: We conducted a pilot study using a single-arm pre-post study design with 10 participants in the LEAD course. The course’s didactic portion taught learners how …

Medical Assistance In Dying: Lessons For Australia From Canada, Jocelyn Downie

Articles, Book Chapters, & Popular Press

Canada has recently witnessed dramatic changes in end-of-life law and policy. Most notably, we have moved from a prohibitive to a permissive regime with respect to medical assistance in dying (MAiD). As a number of Australian states are actively engaged in debates about whether to decriminalise MAiD, it is worth reviewing the Canadian experience and drawing out any lessons that might usefully inform the current processes in Australia.

Newsroom: Is Wall Between Church And State Crumbling? 10-10-2017, Diana Hassel

Life of the Law School (1993- )

No abstract provided.

Reading Alexander V. Choate Rightly: Now Is The Time, Leslie Francis, Anita Silvers

Utah Law Faculty Scholarship

Whatever happens to the Affordable Care Act (ACA) over the next few years, it is fair to assume that state Medicaid programs will be subjected to cost control measures. Despite the recent deployment of substantial arguments to the contrary, the belief still persists that the Supreme Court’s decision in Alexander v. Choate over thirty years ago stands for the proposition that disability anti-discrimination law does not impose requirements on the structure of Medicaid benefits. This belief is misleading at best. In this article, we challenge the access/content distinction and the straitened interpretation of Alexander v. Choate that has resulted from …

Rwu First Amendment Blog: Diana Hassel's Blog: Is The Wall Between Church And State Crumbling? 10-07-2017, Diana Hassel

Law School Blogs

No abstract provided.

"Fowl" Practice Of Humane Labeling: Proposed Amendments To Federal Standards Governing Chicken Welfare And Poultry Labeling Practices, Latravia Smith

Alumni Works

Chickens raised specifically for meat production are the world’s most intensively farmed land animals. Yet, the existing legal frameworks that regulate the production and labeling of poultry products in the United States allow poultry producers to mistreat chickens, falsely distinguish poultry products, and defraud conscious consumers. This article proposes unique opportunities to improve poultry welfare in the United States’ agricultural industry and offers methods to ensure the accurate labeling of poultry products.

Law & Health Care Newsletter, Fall 2017

Law & Health Care Newsletter

No abstract provided.

Mid-Atlantic Ethics Committee Newsletter, Fall 2017

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Key New Hampshire And Federal Statutes Regulating Health Care Delivery And Payment, Lucy Hodder

Law Faculty Scholarship

A summary of New Hampshire and federal regulations by subject matter, chart of New Hampshire state agency responsibilities, federal laws and regulation: An index

Unlocking Exchanges, Brendan S. Maher

Faculty Scholarship

The fate of the Affordable Care Act is uncertain. Moreover, the nation is in an unusual state of political turmoil and may have no appetite for anything other than revolutionary changes to the ACA, if not its outright repeal. But press reports suggest even Republican officials formerly committed to its extirpation are now thinking instead about a measured path forward.

In any event, one fact about the ACA should not escape the attention of serious reformers: the legislation has already accomplished the difficult task of laying the ground work for a move away from employment-based (EB) insurance, a move scholars …

Open Source: The Enewsletter Of Rwu Law 09-22-2017, Roger Williams University School Of Law

Life of the Law School (1993- )

No abstract provided.

Erisa And Graham-Cassidy: A Disaster In Waiting For Employee Health Benefits And For Dependents Under 26 On Their Parents’ Plans, Leslie Francis

Utah Law Faculty Scholarship

Graham Cassidy § 105 would repeal the ACA “employer mandate”. Although its sponsors claim that the bill will give states a great deal of flexibility, it will do nothing to help states ensure that employers provide their employees with decent health insurance; quite the reverse. It will also give employers the freedom to ignore the popular ACA requirement that allows children up to age 26 to receive coverage through their parent’ plans, at least when their parents get health insurance from their employers. Here’s why.

Small Change, Big Consequences — Partial Medicaid Expansions Under The Aca, Adrianna Mcintyre, Allan M. Joseph, Nicholas Bagley

Articles

Though congressional efforts to repeal and replace the Affordable Care Act (ACA) seem to have stalled, the Trump administration retains broad executive authority to reshape the health care landscape. Perhaps the most consequential choices that the administration will make pertain to Medicaid, which today covers more than 1 in 5 Americans. Much has been made of proposals to introduce work requirements or cost sharing to the program. But another decision of arguably greater long-term significance has been overlooked: whether to allow “partial expansions” pursuant to a state Medicaid waiver. Arkansas has already submitted a waiver request for a partial expansion, …

Understanding The Failure Of Health-Care Exceptionalism In The Supreme Court's Obamacare Decision, Abigail Moncrieff

Faculty Scholarship

On June 28, 2012, a mere century after the first presidential proposal for national health insurance, the Supreme Court issued a resounding victory for President Obama and for health-care reform generally, upholding the Patient Protection and Affordable Care Act against a serious constitutional challenge. Nevertheless, the Court also struck a potential blow to future health-care reform efforts. A majority of the Court refused to accept the Solicitor General’s argument that health care is a unique market with unique regulatory needs that justify special constitutional treatment. The failure of health-care exceptionalism in the Court’s opinion might render future reform efforts more …

Substance Use Disorder Treatment Confidentiality Boot Camp, Lucy C. Hodder, Stephanie Cameron, Marcy Doyle, Christina Muñiz, Jeanne Ryer Edd

Law Faculty Scholarship

[Excerpt]: "INTRODUCTION: The Health Law and Policy Programs at UNH School of Law, Institute for Health Policy and Practice, and the NH Citizens Health Initiative have contracted with several of the New Hampshire Building Capacity for Transformation Delivery System Reform Incentive Payment (DSRIP) Integrated Delivery Networks (IDN) to provide technical assistance to the IDNs as they develop confidentiality tools related to substance use disorder services projects.

A UNH Team assisted the IDNs by providing an educational summary of federal and state confidentiality requirements, focusing on 42 CFR Part 2, and hosting IDN interdisciplinary teams in three Substance Use Disorder (SUD) …

Aligning Opioid Prescribing Pathways, Andrea Lai, Outpatient Pharmacy, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

Maine Medical Center

There is a drug epidemic sweeping the State of Maine and it continues to worsen each passing year. In 2017, the Maine legislature passed Public Law Chapter 488 to strengthen the controlled substance prescription monitoring program. An outpatient pharmacy, located in a large acute care hospital, created a performance improvement project to clarify opioid prescription and resolve any non-compliance with Chapter 488.

After a root cause analysis, several KPIs were established to include tracking the number of phone calls made by pharmacists to non-compliant providers to clarify scripts, provide one on one education and ultimately resolve non-compliance. Repeat offenders were …

The Governance Of Indigenous Health, Constance Macintosh

Articles, Book Chapters, & Popular Press

This chapter explores these dynamics of Indigenous health governance in Canada. It opens by describing how Indigenous peoples have successfully used constitutional arguments to assert their own vision of well-being, within the broader context of colonial oppression and attempts to erase Indigenous knowledge and culture. The chapter then tracks federal initiatives on Indigenous health, in their design and outcomes, and how they evolved into the contemporary state governance regime. The next part turns to provincial and self-government initiatives that have expanded, but also complicated, Indigenous health governance in Canada. The chapter closes by considering different ways in which provinces, territories …

Newsroom: Logan Quoted In Bloomberg News On Opiod Litigation 08-16-2017, Jef Feeley, Jared S. Hopkins

Life of the Law School (1993- )

No abstract provided.

Rwu First Amendment Blog: Jared A. Goldstein's Blog: Ri's Conversion Therapy Ban Protects Lgbtq Youth And It's Constitutional 08-09-2017, Jared A. Goldstein

Law School Blogs

No abstract provided.

Does Liberalizing State Nurse Practitioner Scope Of Practice Laws Affect The Primary Care Provider Composition And Productivity In Community Health Centers?, Jeongyoung Park, Xinxin Han, Ellen T. Kurtzman

Health Workforce Research Center Publications

The state scope of practice (SOP) laws determine the range of services nurse practitioners (NPs) can provide and the extent to which they can practice independently. This has been a hot topic amid concerns about primary care provider shortages in light of health reform coverage expansion. Many states consider liberalizing NP SOP laws in an effort to expand primary care capacity. As the demand for primary care increases, NPs are expected to have an active role in meeting primary care needs. The purpose of this study was to examine the effects of expanded nurse practitioner (NP) scope of practice (SOP) …

Early Effects Of The Affordable Care Act On Health Care Access, Risky Health Behaviors, And Self-Assessed Health, Charles J. Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata

Institute for the Study of Free Enterprise Working Papers

The goal of the Affordable Care Act (ACA) was to achieve nearly universal health insurance coverage through a combination of mandates, subsidies, marketplaces, and Medicaid expansions, most of which took effect in 2014. We use data from the Behavioral Risk Factor Surveillance System to examine the impacts of the ACA on health care access, risky health behaviors, and self-assessed health after two years. We estimate difference-in-difference-in-differences models that exploit variation in treatment intensity from state participation in the Medicaid expansion and pre-ACA uninsured rates. Results suggest that the ACA led to sizeable improvements in access to health care in both …