Health Law and Policy Commons^™

Medical-Legal Partnerships With Communities: Legal Empowerment To Transform Care, Tamar Ezer

Articles

Medical-legal partnerships (MLPs) integrate legal services into health care settings to provide holistic care and address the social determinants of health. This article brings a legal-empowerment lens to MLP work, arguing for a stronger focus on communities. It examines the application to MLPs of bringing services to communities, investing in rights literacy, and partnering with community-based paralegals. It then outlines the potential for a transformation in health and legal services to a rights - rather than needs-based framework where communities are active partners in program design and development.

No One Statute Should Have Too Much Power: How Electing Not To Amend 42 U.S.C § 1320(A)–7(B) May Frustrate The Purpose Of The Patient Protection And Affordable Care Act, Amber C. Dawson

University of Miami Business Law Review

The over breadth of the Federal Anti-Kickback statute as amended by the Patient Protection and Affordable Care Act (PPACA) holds dangerous implications for the future of the health care marketplace. When a statute permits criminal, civil and administrative punishment for an overbroad category of innocuous actions, such a statute must also take into account the specific, rather than general, intent of the actor, or the ensnaring of innocents is ultimately likely to result. Historically, the statute required a finding of specific intent to be found to uphold a violation of the statute. With the passing of Greber v. US and …

International Reciprocity: If A Drug Is Good Enough For Great Britain, It Should Be Good Enough For The United States, Nicole C. Perez

University of Miami Business Law Review

The pharmaceutical industry is one of the largest, and most lucrative, industries in the world, worth about one trillion U.S. dollars. Specifically, the United States accounts for more than one-third of the global pharmaceutical market with about 340 million dollars in sales. Not only is the pharmaceutical industry one of the biggest industries profit-wise, but it is also an industry that affects almost every single person in the world. In a nation where healthcare issues are always on the rise, ensuring that American citizens benefit from pharmacology is essential to improving the nation’s healthcare system. The Food and Drug Administration …

The Heartbreak Of Not Making Automated External Defibrillators Available For Public Use, Samuel D. Hodge Jr., Daria Koscielniak

University of Miami Law Review

An automated external defibrillator (AED) is one of the greatest advancements in defibrillator technology in the past several decades. Its purpose is to treat sudden cardiac arrest, the leading cause of death in this country. An AED checks the heart’s rhythm and will dispatch an electric jolt when needed to reestablish the organ’s normal electrical pattern. The magic of this portable device is that anyone can use it and it is relatively inexpensive to purchase. Studies have shown that access to AEDs can improve the odds of surviving a cardiac arrhythmia outside of the hospital and the American Heart Association …

A Promise Realized? A Critical Review Of Accountable Care Organizations Since The Enactment Of The Affordable Care Act, Jean Phillip Shami

University of Miami Law Review

As the six-year anniversary of the passage of the Affordable Care Act (“ACA”) comes to a close, a critical review of one of the key inventions of the ACA—Accountable Care Organizations (“ACOs”)—is timely as part of the greater narrative around affordable, quality health care in America. This Comment begins with a discussion of the statutory creation, philosophy and vision, and organizational structure of ACOs in the context of the passage of the ACA in 2010. Then, it will critically review ACOs from three perspectives based on the ACO model’s mission to provide better care for more people at a lower …

Paternalism, Self-Governance, And Public Health: The Case Of E-Cigarettes, Wendy E. Parmet

University of Miami Law Review

This article develops a normative framework for assessing public health laws, using the regulation of e-cigarettes as a case study. Although e-cigarettes are likely far less dangerous to individual users than traditional cigarettes, it remains uncertain whether their proliferation will lead to a reduction of smoking-related disease and deaths or to increased morbidity and mortality. This scientific uncertainty, whether and how to regulate e-cigarettes. This article presents a normative framework for analyzing such questions by offering three justifications for public health laws: impaired agency, harm to others, and self-governance. Each justification responds to the common charge that public health laws …

The Contraception Mandate Accomodated: Why The Rfra Claim In Zubik V. Burwell Fails, Caroline Mala Corbin

Short Works

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Deference To Claims Of Substantial Religious Burden, Caroline Mala Corbin

Articles

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Dignifying Madness: Rethinking Commitment Law In An Age Of Mass Incarceration, Jonathan Simon, Stephen A. Rosenbaum

University of Miami Law Review

Modern nation-states have been trapped in recurring cycles of incarcerating and emancipating residents with psychiatric disabilities. New cycles of enthusiasm for incarceration generally commence with well-defined claims about the evils of allowing “the mad” to remain at liberty and the benefits incarceration would bring to the afflicted. A generation or two later, at most, reports of terrible conditions in institutions circulate and new laws follow, setting high burdens for those seeking to imprison and demanding exacting legal procedures with an emphasis on individual civil liberties. Today, we seem to be arriving at another turn in the familiar cycle. A growing …

Trafficked? Aids, Criminal Law And The Politics Of Measurement, Aziza Ahmed

University of Miami Law Review

Since early in the HIV epidemic, epidemiologists identified individuals who transact sex as a high-risk group for contracting HIV. Where the issue of transacting sex has been framed as sex work, harm-reduction advocates and scholars call for decriminalization as a primary legal solution to address HIV. Where the issue is defined as trafficking, advocates known as abolitionists argue instead for the criminalization of the purchase of sex.

Global health governance institutions are porous to these competing ideas and ideologies. This article first historicizes the contestation between harm-reduction and abolition in global governance on health. The paper then turns to a …

Ebola, Quarantine, And Flawed Cdc Policy, Robert Gatter

University of Miami Business Law Review

The CDC’s Interim Guidance for Monitoring and Movements of Persons with Potential Ebola Virus Exposure is deeply flawed because it disregards the science of Ebola transmission. It recommends that officials quarantine individuals exposed to the virus but who do not have any symptoms of illness, ignoring the fact that only those with Ebola symptoms can communicate the virus to others. Consequently, any quarantine order based on the Guidelines is surely unconstitutional and illegal under most states’ public health statutes—as exemplified by the State of Maine’s failed petition to quarantine Nurse Kaci Hickox in October 2014. This article examines the Guidance …

Pharmaceuticals And Biopiracy: How The Aia May Inadvertently Reduce The Misappropriation Of Traditional Medicine, Ryan D. Levy, Spencer Green

University of Miami Business Law Review

For decades, Eastern traditional medicine has been misappropriated by others who claim it as their own and attempt to obtain patent protection for it. As long this practice has existed, the international community has pushed back against it. Several countries and international bodies have created databases of traditional knowledge, hoping to preclude the issuance of patents on that knowledge. Other countries, like Thailand, have extended intellectual property protection to the traditional knowledge stakeholders themselves. However, a recent change to US patent law may have the unintended consequence of helping resolve the issue of biopiracy

Legal, Operational, And Practical Considerations For Hospitals And Health Care Providers In Responding To Communicable Diseases Following The 2014 Ebola Outbreak, Jane Jordan, Greg Measer, Asha Agrawal, James G. Hodge Jr.

University of Miami Business Law Review

This article analyzes some of the potential issues that may arise during epidemics or other public health emergencies. It specifically focuses on legal and operational preparedness experiences at Emory University during the 2014 Ebola crisis. Emory University Hospital was the first health care facility in the U.S. to treat patients diagnosed with Ebola Viral Disease (EVD). Although EVD has particularly frightening symptoms and a high mortality rate, its containment and treatment implicate similar legal, practical, and operational issues as other highly infectious and communicable diseases. These issues include laws related to: isolation and quarantine; travel restrictions; duties to treat highly …

Wollschlaeger, A Patient’S Right To Privacy, And A Renewed Focus On Mental Health Treatment, Chad A. Pasternack

University of Miami Business Law Review

In response to doctors pushing gun control agendas on patients, Florida enacted the Firearm Owners Privacy Act. The law, upheld by the Eleventh Circuit in Wollschlaeger v. Governor of Florida, protects patients from intrusive lines of inquiry unrelated to their treatment and from discrimination due to firearm ownership. While patients in Florida benefit greatly from the Firearm Owners Privacy Act, this note argues for more specific language in the law, which would parallel language in the Florida Mental Health Act (“Baker Act”). The proposed changes would limit inquiries into firearm ownership to instances where there is a substantial likelihood …

Terminating The Hospital-Physician Employment Relationship: Navigating Conflicts Arising From The Physician’S Dual Roles As Employee And Medical Staff Member, Gayland Hethcoat

University of Miami Business Law Review

In an effort to meet the challenges of the post-health reform marketplace, hospitals have accelerated the practice of employing physicians. Despite this trend, many hospitals require their employed physicians to also maintain membership and privileges on the medical staff—the self-governing entity comprised of fellow physicians that oversees the practice of medicine within the hospital setting. Recent case law identifies at least two salient issues that will likely arise from physicians’ dual roles as hospital employee and medical staff member and be a point of negotiation and litigation: (1) the applicability of “due process” rights, which are typically afforded in medical …

King V. Burwell And The Rise Of The Administrative State, Ronald D. Rotunda

University of Miami Business Law Review

The Patient Protection and Affordable Care Act—popularly called either the “ACA,” or “Obamacare” by opponents, proponents, and even the White House—is a complex law totaling nearly a thousand pages in length. The litigation now before the Supreme Court in King v. Burwell presents, on the surface, a simple issue of statutory interpretation. However, that surface has a very thin veneer. If the Court allows administrators carte blanche to change the very words of a statute, we will have come a long way towards governance by bureaucrats. Over the years, Congress has delegated many of its powers, but it has never …

From The New Deal To The New Healthcare: A New Deal Perspective On King V. Burwell And The Crusade Against The Affordable Care Act, Sarah Helene Duggin

University of Miami Business Law Review

Americans describe the new healthcare system established by the Patient Protection and Affordable Care Act (“ACA”) as both a blessing and a nightmare. For millions of low and middle income Americans, the ACA offers access to health insurance they could not otherwise afford. The ACA’s opponents, however, view the new healthcare system as a threat to economic prosperity, an intrusion on personal liberty and a violation of the principles of federalism at the heart of our system of government. These same kinds of arguments were made more than eighty years ago in response to President Franklin Delano Roosevelt’s New Deal. …

Unfair Coercion, Or Greater Deference? Two New Sides Of King V. Burwell, Tom Miller

University of Miami Business Law Review

Litigation challenging the legality of an Internal Revenue Service rule that became final on May 2012 has traveled a long, winding, and contentious path. The IRS rule authorized the distribution of federal premium assistance tax credits in all health benefits exchanges under the Patient Protection and Affordable Care Act of 2010 (the “ACA”). However, potential legal problems with reconciling various sections of the final legislation involving those tax credits were identified as early as December 6, 2010. On September 19, 2012, the first of four different legal challenges to the IRS rule was filed in federal district court in Oklahoma. …

The Subsidy Question In King V. Burwell—A Federalist Response To Crony Capitalism, Antonio F. Perez

University of Miami Business Law Review

On the surface, King v. Burwell appears to be a simple case about statutory interpretation. In the Affordable Care Act (widely known as Obamacare), when Congress referred to the “State,” in the provision triggering federal subsidies to insurance consumers for purchases made from federally-authorized insurance providers selling federally-authorized insurance products, should the “State” be understood to refer to the federal market (i.e., exchanges) as well as “State” markets. Simple tools of statutory construction–namely, that Congress knew full well how to refer to a “federal” exchange and failed to do so–would seem to be sufficient to supply a result. It would …

Anomalies In The Affordable Care Act That Arise From Reading The Phrase “Exchange Established By The State” Out Of Context, Timothy Stoltzfus Jost, James Engstrand

University of Miami Business Law Review

The Supreme Court is currently considering in King v. Burwell whether residents of all States can receive premium tax credits under the Patient Protection and Affordable Care Act (ACA). The Plaintiffs-Petitioners brought this litigation as a challenge to the validity of a Treasury Department rule allowing all ACA health insurance Exchanges or marketplaces, including federally facilitated Exchanges (FFEs), to support and grant the credits. They invite the Court to focus solely on four words in two subsections of Section 36B of the Internal Revenue Code that they interpret as limiting tax credits to individuals who can use a State-operated Exchange …

Corporate Religious Liberty, Caroline Mala Corbin

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Investment Arbitration In East Asia And The Pacific A Statistical Analysis Of Bilateral Investment Treaties, Other International Investment Agreements And Investment Arbitrations In The Region, Sandra Friedrich, Claudia T. Salomon

Articles

Many countries in the East Asian and Pacific (EAP) region have strengthened their networks of bilateral investment treaties (BITs) and other international investment agreements (IIAs). This growth in investment protection instruments not only illustrates the region's continued attractiveness to foreign investors, but also reflects a shift of several developing EAP countries from having been predominantly recipients of foreign investment in the past, toward becoming important sources of foreign investment abroad. Reflecting trade and investment patterns, as of December 2014, EAP countries concluded a total of at least 712 BITs and 69 other IlAs. On the heels of this development, the …

Standing (In) For The Government, Sergio J. Campos

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Abortion Distortions, Caroline Mala Corbin

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Comparative Pragmatism Versus Comparative Formalism In The Abortion Context, Caroline Bettinger-López

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Does The Individual Mandate Coerce?, Raphael Boleslavsky, Sergio J. Campos

Articles

The Patient Protection and Affordable Care Act includes an individual mandate that penalizes individuals who do not purchase health insurance. Critics of the individual mandate, including a majority of justices on the Supreme Court, contend that Congress cannot use its Commerce Clause power to coerce individuals to buy a product. Supporters concede that the mandate coerces but argue that it is otherwise permissible under the Commerce Clause. This article questions whether the individual mandate coerces. It uses a simple economic model to show that, under certain conditions, the individual mandate induces insurers to sell health insurance at a price each …

The Contraception Mandate, Caroline Mala Corbin

Articles

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.

Miami's Medical-Legal Partnership: Preparing Lawyers And Physicians For Holistic Practice, Jonel Newman

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Debate: The Contraception Mandate And Religious Freedom, Steven D. Smith, Caroline Mala Corbin

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Beyond Separation In Federalism Enforcement: Medicaid Expansion, Coercion, And The Norm Of Engagement, Charlton C. Copeland

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National Federation of Independent Business v. Sebelius may be known, in both the popular and academic commentaries, as the case about the Affordable Care Act's Individual Mandate provision. History may record it as one of the most significant cases in the jurisprudence of cooperative federalism. In invalidating part of the Medicaid Expansion provision, the Roberts Court became the first to invalidate a federal spending statute as unconstitutionally coercive of state governments. This decision has the potential to impact federal-state cooperative arrangements such as No Child Left Behind, and others far beyond the health care context.

This Article argues that lack …