Law Commons^™

The Drug (Pricing) Wars: States, Preemption, And Unsustainable Prices, Isaac ("Zack") D. Buck

Scholarly Works

It is no secret: the prices of prescription drugs in the United States are unsustainable. A piercing example of the limits of America’s incomplete and disordered health care non-system, the crisis has only worsened in recent years. And not only do drug prices exact a toll on America’s consumers, they impact Americans’ access to life-enhancing (and sometimes life-saving) drugs. They constitute a real and present threat to the quality of health care in the United States in 2020.

Recognizing this harm, states are increasingly operating in this space, seeking diverse regulatory solutions to better protect their citizens — from gouging …

Breaking The Fever: A New Construct For Regulating Overtreatment, Isaac ("Zack") D. Buck

Scholarly Works

The Department of Justice’s (“DOJ”) current theory of overtreatment regulation — and, in fact, all of the prominent amount of medical necessity-based health care fraud enforcement — adopts the argument that providers are violating the False Claims Act when they submit bills to the federal government for care they administered that is not medically necessary. Besides stoking the ire of the provider community, this regulatory strategy is susceptible to inefficiency, imprecision, and — as I have argued before — overuse. Whether a procedure was medically necessary can be a highly difficult question to answer, one easily swayed by clinically-complex details, …