Law Commons^™

Status Quo Kewenangan Perusahaan Asuransi Dalam Menerbitkan Produk Penjaminan Pasca Berlaku Efektifnya Undang-Undang No. 1 Tahun 2016 Tentang Penjaminan, Kalih Krisnareindra

"Dharmasisya” Jurnal Program Magister Hukum FHUI

Risk is something that is always exist in various type of business. Risk management commonly used the assistance of insurance companies to manage its risk by risk transfer. The current prevailing law allows the insurance industry to develop its products wider than the explicitly defined business lines in the regulation. Historically, the guarantee/surety business has been marketed jointly between insurance companies and guarantee/surety companies. This can be traced through laws and regulations that provide the authority to both type of companies to issue guarantee/surety products. But with the enactment of Law No. 1 of 2016 concerning Guarantees, there is an …

Pertanggungjawaban Otoritas Jasa Keuangan Terhadap Kasus Gagal Bayar Perusahaan Asuransi, Tumbur Halomoan

"Dharmasisya” Jurnal Program Magister Hukum FHUI

The development of the financial industry accompanied by close supervision in order to maintain stability in the financial industry. Financial Services Authority is an independent institution have special authority by the Law to overseen the financial industry. The financial industry is divided into two parts first the bank financial industry and the non-bank financial industry. One non-bank financial industry that is overseen by OJK. OJK in overseeing insurance is quite large starting from the granting of a company establishment license to the company's activities which are reported regularly by the insurance company. OJK not necessarily make the insurance industry run …

Peer Review/Ethics: How Can Our Office Be More Inclusive Of Transgender Patients?, Debra Peters Dds

The Journal of the Michigan Dental Association

In this professional ethics article, Dr. Debra Peters of the ADA’s Council on Ethics, Bylaws and Judicial Affairs addresses the need for dental teams to be more inclusive of transgender patients, emphasizing the challenges faced by transgender and gender non-conforming (TGNC) individuals in accessing dental care. The article recommends providing training and resources for dental teams, highlighting the importance of first impressions and effective communication during patient interactions. Practical suggestions include incorporating affirmed name and gender options in registration forms, ensuring appropriate language in interactions, and addressing insurance claim discrepancies. The column promotes creating a respectful environment and cites the …

Insuring Contraceptive Equity, Jennifer Hickey

Northwestern Journal of Law & Social Policy

The United States is in the midst of a family planning crisis. Approximately half of all pregnancies nationwide are unintended. In recognition of the social importance of family planning, the Affordable Care Act (ACA) includes a “contraceptive mandate” that requires insurers to cover contraception at no cost. Yet, a decade after its enactment, the ACA’s promise of universal contraceptive access for insured women remains unfulfilled, with as many as one-third of U.S. women unable to access their preferred contraceptive without cost.

While much attention has been focused on religious exemptions granted to employers, the primary barrier to no-cost contraception is …

Debunking The Standardized Nature Of Insurance Policies, Elizabeth Sousa

Fordham Journal of Corporate & Financial Law

This article discredits the conventional view of insurance policies as standardized contracts that do not vary across insurance companies and policyholders. Contrary to this view, there are wide variations in policy language in both the admitted and non-admitted insurance markets. These deviations reduce the perceived benefit of insurance policies as standardized contracts intended to promote predictability and lower transaction costs for policyholders by focusing only on the most salient terms. Nowhere is this deviation more apparent than with Commercial General Liability (CGL) policies defendants are turning to in the current opioid litigation.

The opioid epidemic has been plaguing the United …

The Limits Of Regulation By Insurance, Kenneth S. Abraham, Daniel Benjamin Schwarcz

Indiana Law Journal

Insurance is an enormously powerful and beneficial method of spreading risk and compensating for loss. But even insurance has its limits. A new and misleading aspiration for insurance—that it also can and often does substitute for or significantly complement health and safety regulation—is increasingly in vogue. This vision starts from the uncontroversial recognition that insurers typically adopt measures designed to counteract “moral hazard,” the tendency of insurance to blunt policyholders’ incentives to take care. But proponents of this vision go on to contend that the risk-reducing potential of insurance is significantly more extensive than is traditionally imagined, because insurers are …

J Mich Dent Assoc December 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• Two cover stories presenting perspectives from both ends of the practice life continuum: “Starting Your Practice Life” and “Preparing for Retirement”.
• A feature article, “What Happened in Vegas Became ADA Policy”.
• A feature article, “An Oversight Corrected: 2020 MDA Life Members Recognized”.
• The 2021 Author/Title Index to the Journal of the Michigan Dental Association. …

Finding Parity Through Preclusion: Novel Mental Health Parity Solutions At The State Level, Ryan D. Kingshill

Dickinson Law Review (2017-Present)

Recently, the federal government has taken numerous steps to promote the equal treatment (also known as parity) of mental and physical health issues. The two most impactful actions are the Mental Health Parity and Addiction Act of 2008 and the Affordable Care Act. These acts focus on the traditional avenue for parity change—insurance regulation. While these acts have improved parity, major gaps in coverage and treatment between mental health/substance use disorder treatment and medical/surgical treatment persist. ERISA Preemption, evasive insurer behavior, lack of enforcement, and lack of consumer education continue to plague patients and healthcare professionals. On its own, federal …

The Early Impact Of The Affordable Care Act Upon Colorectal Cancer Screening Utilization In Florida, Aldenise P. Ewing, Laura Baum, Rosalyn Roker, Marlene Joannie Bewa, Tali Schneider, Claudia F. Parvanta, Clement K. Gwede, Cathy D. Meade, Dinorah Martinez Tyson

Journal of Health Disparities Research and Practice

Background: Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Although preventable and curable through screening, early detection and treatment, a lack of health insurance is a major obstacle to receiving colorectal cancer screening (CRCS). Despite the Affordable Care Act (ACA) increasing access to health insurance by mandating coverage of CRCS, disparities in utilization rates continue. Therefore, researchers sought to better understand ACA related facilitators and impediments that affect the utilization of CRCS and collect specific recommendations from healthcare professionals to increase screening utilization rates in Florida.

Methods: Researchers conducted in-depth interviews with …

Sb 18 - Direct Primary Care, Valentin H. Dubuis, Juliana Mesa

Georgia State University Law Review

This legislation allows physicians to offer specified care for a specific time pursuant to a fixed fee. The physician cannot require more than one year’s payment upfront, and the agreement has to be terminable by either party with thirty days’ notice. Physicians do not have to provide care if the fee has not been paid or the patient has committed fraud, failed to adhere to treatment, or is in physical danger.

Bad Company? The Rise (Again) Of Association Health Plans, Brendan Williams

The Journal of Business, Entrepreneurship & the Law

This article first examines the rule adopted by the DOL and the criticism it has drawn. It then assesses the state of the small-group insurance market for small businesses, and the flawed approach that the ACA took to assisting them. Finally it takes a look at the uncertain future for small businesses and health insurance, and it suggests new approaches

A Prescription For Charity Care: How National Medical Debt Ills Can Be Alleviated By Integrating State Financial Assistance Policies Into The Nonprofit Tax Exemption, Margarita Kutsin

Seattle University Law Review

Despite having the most expensive healthcare system in the world, the United States has been consistently ranked as having the worst system in terms of equity, efficiency, and healthcare outcomes among industrialized nations. The effects of these systemic issues are grounded in the patient experience as nearly forty-four percent of individuals have forgone recommended treatments and thirty-two percent have reported that they were unable to afford a prescription due to the high cost, according to a study conducted in 2018. Health is sacred, and financial circumstances should not determine the difference between treatment and illness, or life and death. “Financial …

Too Clever By Half: Commanding The Nonuse Of State Authority To Regulate Health Benefits In The Aca, Michael F. Ryan

University of Massachusetts Law Review

Prior to the enactment of the Patient Protection and Affordable Care Act (ACA), state legislatures routinely passed laws requiring health insurance carriers to cover certain health care services or providers. At the behest of the insurance industry, Congress attempted to use the health reform law as a vehicle to reign in state-specific “mandated benefit” laws. That being said, the ACA does not prevent states from enacting mandated benefit laws; in fact, the statute expressly permits states to enact such laws. Instead, Congress created a significant barrier to continued state-specific regulation of health insurance benefits. Specifically, 42 U.S.C. § 18031(d)(3)(B)(ii) (Section …

Medicaid: Welfare Program Of Last Resort, Or Safety Net?, Laura D. Hermer

Mitchell Hamline Law Review

No abstract provided.

Provider Liability And Medical Identity Theft: Can I Get Your (Insurance) Number?, Thomas Clifford

Northwestern Journal of Law & Social Policy

No abstract provided.

The Patient Protection And Affordable Care Act And Choice In Childbirth: How The Aca's Nondiscrimination Provisions May Change The Legal Landscape Of Childbirth, Caitlin Mccartney

American University Journal of Gender, Social Policy & the Law

No abstract provided.

The Aca’S 2017 State Innovation Waiver: Is Erisa A Roadblock To Meaningful Healthcare Reform?, Marea B. Tumber

University of Massachusetts Law Review

In 2017, the Affordable Care Act’s (ACA) State Innovation Waiver (§1332) will enable states to waive many of the ACA’s provisions and to develop their own creative solutions to reign in healthcare spending. The Employee Retirement Income Security Act of 1974 (ERISA) was enacted to encourage employers to sponsor benefit plans and minimize potential conflicts with existing state laws. Because of ERISA, the regulation of employee benefit plans, including health plans, falls primarily under federal jurisdiction for about 131 million people. This Note explores the ways in which ERISA presents significant roadblocks to meaningful state level healthcare reform under §1332. …

The Contraception Mandate, Caroline Mala Corbin

Northwestern University Law Review

Under the new health care regime, health insurance plans must cover contraception. While religious employers are exempt from this requirement, religiously affiliated employers are not. Several have sued, claiming that the “contraception mandate” violates the Free Exercise Clause, the Free Speech Clause, and the Religious Freedom Restoration Act. This Essay explains why the contraception mandate violates none of them.

Maria’S Law: Extending Insurance Coverage For Fertility Preservation To Cancer Patients In Massachusetts, Brittany Raposa

University of Massachusetts Law Review

This Note addresses the issues related to fertility preservation treatments for cancer patients in the context of insurance coverage. As cancer survival rates improve, the ability to bear children after therapy is increasingly difficult and a concern for most patients. Currently, no states have laws requiring insurance coverage for fertility preservation treatments for cancer patients. Because it is not currently covered by either private or public insurance, only those who can pay for it on their own can use fertility preservation treatments. This note proposes that Massachusetts, as having one of the most inclusive infertility health insurance mandates, should expand …

Court Of Appeals Of New York, Consumers Union Of United States, Inc. V. New York, Daphne Vlcek

Touro Law Review

No abstract provided.

The Unintended Federalism Consequences Of The Affordable Care Act’S Insurance Market Reforms, Joshua Phares Ackerman

Pace Law Review

This Article, which is the first to examine the relationship between the ACA’s insurance market reforms and state regulation of insurance, argues that states’ decisions to forego creating their own exchanges may mark the beginning of an important shift of regulatory authority from the states to the federal government. It begins by sketching the historical antecedents of the current allocation of state and federal authority over insurance regulation. The aim of this discussion is to highlight the unique role states play in the regulation of insurance as opposed to other financial products. Part III explains the pre-ACA structure of health …

Silence Is Golden...Except In Health Care Philanthropy, Stacey A. Tovino

University of Richmond Law Review

No abstract provided.

Liability Cure-All For Insidious Disease Claims, Susan Frankewich

Pepperdine Law Review

Recent decisions handed down in various circuits have created virtual chaos in predicting the liability and damage amounts of insidious disease claims. At least three substantially divergent theories have been adopted to impute liability to the manufacturers of the disease catalysts. Additionally, a new trust fund concept has been used on a limited basis to reconcile differences in court decisions. The trust fund approach is relatively flexible and simple to apply in apportioning damages for insidious disease claims. The author examines and analyzes these three liability theories. In conclusion, the adoption of the trust fund concept is recommended.

Employers’ Use Of Health Insurance Exchanges: Lessons From Massachusetts, Mark A. Hall

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Sacrificial Lambs: Compensating First Subscribers To Fda-Approved Medications For Postmarketing Injuries Resulting From Unlabeled Adverse Events, Rodney K. Miller

Catholic University Law Review

No abstract provided.

Health Care Providers Meet Erisa: Are Provider Claims For Misrepresentation Of Coverage Preempted, Jeffrey A. Brauch

Pepperdine Law Review

No abstract provided.

The Rhetoric Hits The Road: State Challenges To The Affordable Care Act Implementation, Elizabeth Weeks Leonard

University of Richmond Law Review

No abstract provided.

It Is Not Too Late For The Health Savings Account, Jessica A. Bejerea

Chicago-Kent Law Review

The Health Savings Account (HSA), a tax-advantaged savings vehicle for paying medical expenses, paired with the high deductible health plan, has become a popular means of controlling health care costs and insurance premiums. Recently Congress attempted to increase the attractiveness of the HSA and the high deductible health plan when it amended HSA law in 2006. This note examines these recent changes and argues that certain provisions of the amendments, along with IRS guidance, have instead complicated the rules for HSAs and have neglected to resolve at least one important issue.

Health Care Law, Kathleen M. Mccauley, Kristi L. Vanderlaan

University of Richmond Law Review

No abstract provided.

Patients As Consumers: Courts, Cotnracts, And The New Medical Marketplace, Mark A. Hall, Carl E. Schneider

Michigan Law Review

The persistent riddle of health-care policy is how to control the costs while improving the quality of care. The riddle's oncepromising answer-managed care-has been politically ravaged, and consumerist solutions are now winning favor This Article examines the legal condition of the patient-as-consumer in today's health-care market. It finds that insurers bargain with some success for rates for the people they insure. The uninsured, however, must contract to pay whatever a provider charges and then are regularly charged prices that are several times insurers'pricesa nd providers' actual costs. Perhaps because they do not understand the healthcare market, courts generally enforce these …