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Articles 421 - 450 of 531
Full-Text Articles in Health Law and Policy
The Government, The Legislature And The Judiciary - Working Towards Remedying The Problems With The Civil False Claims Act: Where Do We Go From Here?, Raegan A. Mcclain
The Government, The Legislature And The Judiciary - Working Towards Remedying The Problems With The Civil False Claims Act: Where Do We Go From Here?, Raegan A. Mcclain
Annals of Health Law and Life Sciences
Ms. McClain examines the government's role in developing and applying the False Claims Act. The article explores the use and effectiveness of the False Claims Act to target fraud and other abuses in the health care system. The article then addresses past inequitable misuse of the Act resulting from improper judicial interpretation of the Act and offers suggestions for curbing some of the stricter provisions of the Act.
Responsive Regulation Of Internet Pharmacy Practice, David B. Brushwood
Responsive Regulation Of Internet Pharmacy Practice, David B. Brushwood
Annals of Health Law and Life Sciences
Professor Brushwood discusses the effectiveness of the Internet as a medium for carrying out pharmaceutical care. A proponent of Internet pharmacy, Professor Brushwood argues that pharmacy regulators could best protect and promote public health through responsive Internet regulation. Wary of state paternalism, the article advocates the Verified Internet Pharmacy Practice Site program of the National Association of Boards of Pharmacy as a model method for regulating pharmacy practices over the Internet.
Foreword, John D. Blum, Joan H. Krause, Lawrence E. Singer [email protected]
Foreword, John D. Blum, Joan H. Krause, Lawrence E. Singer [email protected]
Annals of Health Law and Life Sciences
No abstract provided.
Table Of Contents, Annals Of Health Law
Table Of Contents, Annals Of Health Law
Annals of Health Law and Life Sciences
No abstract provided.
Telemedicine: The Invisible Legal Barriers To The Health Care Of The Future, Heather A. Daley
Telemedicine: The Invisible Legal Barriers To The Health Care Of The Future, Heather A. Daley
Annals of Health Law and Life Sciences
Telemedicine has the potential to transform the world of health care just as the Internet transformed the world of commerce. Ms. Daly examines two legal obstacles to expanding the use of telemedicine: licensure and liability. She defines telemedicine and discusses its common applications and significant benefits. Licensure laws and liability rules result in formidable barriers to the expanded use of telemedicine, while also failing to provide sufficient protection for consumers. Ms. Daly argues that for the benefits of telemedicine to reach those most in need, mutual recognition of licensing laws coupled with a universal standard of care is necessary.
The Attorney/Client Privilege: A Fond Memory Of Things Past: An Analysis Of The Privilege Following United States V. Anderson, Michael M. Mustokoff, Jonathan L. Swichar, Cheryl Roth Herzfeld
The Attorney/Client Privilege: A Fond Memory Of Things Past: An Analysis Of The Privilege Following United States V. Anderson, Michael M. Mustokoff, Jonathan L. Swichar, Cheryl Roth Herzfeld
Annals of Health Law and Life Sciences
Mr. Mustokoff, Mr. Swichar, and Ms. Herzfeld address the rudiments of the attorney/client privilege, its crime-fraud exception, corporate compliance programs, the United States government's quest for voluntary disclosure, and how those principles have been affected by United States v. Anderson.
A Critical Analysis Of Health And Human Services' Proposed Health Privacy Regulation In Light Of The Health Insurance Privacy And Accountability Act Of 1996, A. Craig Eddy
Annals of Health Law and Life Sciences
Dr. Eddy inquires, through a detailed analysis of relevant statutory provisions, whether it is likely that the HIPAA legislation or the Standards for Privacy of Individually Identifiable Health Information Regulations (SPIIHI) proposed by HHS will efficiently and cost effectively defend the privacy issues they were intended to safeguard. His paper critically analyzes the extremely broad and expensive course of action and tactics HHS has chosen to employ in this effort to determine whether HHS' proposal is an efficient use of health care dollars. To introduce his analysis, Dr. Eddy addresses the general concept of medical privacy and attempts to define …
Administrative Channeling Under The Medicare Act Clarified: Illinois Council, Section 45(H), And The Application Of Congressional Intent, John Aloysius Cogan Jr., Rodney A. Johnson
Administrative Channeling Under The Medicare Act Clarified: Illinois Council, Section 45(H), And The Application Of Congressional Intent, John Aloysius Cogan Jr., Rodney A. Johnson
Annals of Health Law and Life Sciences
Mr. Cogan and Mr. Johnson discuss the judicial review provisions of the Medicare Act, codified at 42 U.S.C. section 405(g) and (h), and the Supreme Court cases including Illinois Council that interpret the scope of the "arising under" language. They also examine the history of section 205(h) of the Social Security Act, including the most recent amendment contained in the Deficit Reduction Act of 1984. The relationship between 205(h), DEFRA, and section 405(h) is explored as well as the caselaw addressing and applying section 405(h) in light of Congress' 1984 amendments.
The Anti-Kickback Statute Standard(S) Of Intent: The Case For A Rule Of Reason Analysis, Timothy J. Aspinwall
The Anti-Kickback Statute Standard(S) Of Intent: The Case For A Rule Of Reason Analysis, Timothy J. Aspinwall
Annals of Health Law and Life Sciences
Mr. Aspinwall presents a comprehensive overview of the anti-kickback statute to show how Congress enacted the legislation to prevent inappropriate utilization and to reduce the ambiguity of the anti-kickback prohibitions by adding a knowing and willful requirement to the standard of intent. He discusses the different lines of caselaw on the anti-kickback standard of intent, and closely examines the standard endorsed by the OIG. He proposes adopting a standard of reasonableness modeled after the rule of reason from antitrust law, using cost-effectiveness as the primary criterion. He argues that a cost-benefit outcomes-based approach to the anti-kickback statute would better serve …
Informing, Claiming, Contracting: Enforcement In The Managed Care Era, Louise G. Trubek
Informing, Claiming, Contracting: Enforcement In The Managed Care Era, Louise G. Trubek
Annals of Health Law and Life Sciences
Professor Trubek describes the role of the states in patient and consumer protection in the managed care era. In particular, this article focuses on the managed care patient protection mechanisms used in Wisconsin: informing consumers, encouraging dispute resolution and influencing contracts. The discussion includes an analysis of the effects of these mechanisms on the actors in the health care regulatory area and concludes with an assessment of the actors' adaptations.
The Coming Millennium: Enduring Issues Confronting Catholic Health Care, Lawrence E. Singer, Elizabeth Johnson Lantz
The Coming Millennium: Enduring Issues Confronting Catholic Health Care, Lawrence E. Singer, Elizabeth Johnson Lantz
Annals of Health Law and Life Sciences
Professor Singer and Ms. Johnson Lantz provide a cogent overview of Catholic health care in the United States and address the key issues affecting Catholic health care in the coming years. In particular, (1) clarity in canonical and ethical interpretation; (2) industry consolidation; and (3) "next generation" sponsorship and the impact of these issues are discussed in detaiL The authors conclude that successful Catholic health care organizations must maintain strong mission and business fundamentals in an increasingly competitive reimbursement and regulatory environment.
Splitting Fees Or Splitting Hairs? Fee Splitting And Health Care - The Florida Experience, Richard O. Jacobs, Elizabeth Goodman
Splitting Fees Or Splitting Hairs? Fee Splitting And Health Care - The Florida Experience, Richard O. Jacobs, Elizabeth Goodman
Annals of Health Law and Life Sciences
Attorneys Jacobs and Goodman review the prohibitions against fee-splitting under Florida law and argue that Florida and other states need a clear statutory definition of prohibited activities. In addition, the authors argue that the Florida Board of Medicine has applied the prohibition against fee-splitting arbitrarily and in contrast to legal precedent set by the Second District Court of Appeals. Finally, the authors suggest that Minnesota provides clear legislative guidance on the issue of fee-splitting and that the approach adopted by Minnesota is more practical in today's complex health care reimbursement environment.
Federalism And Managed Care: Introductory Comments To The American Association Of Law Schools' Section On Law, Medicine And Health Care On The Role Of The States In Managed Care Regulation, John D. Blum
Annals of Health Law and Life Sciences
This section of the Annals of Health Law represents a compilation of materials concerning the state regulation of managed care. The following materials were first presented at the annual meeting of the American Association of Law Schools ("AALS"), Section on Law, Medicine and Health Care in January 1999. Chairman John Blum introduces the subject and questions the dual role assumed by state and federal authorities in regulating managed care.
Crossroads In Hospital Conversions - A Survey Of Nonprofit Hospital Conversion Legislation, Kevin F. Donohue
Crossroads In Hospital Conversions - A Survey Of Nonprofit Hospital Conversion Legislation, Kevin F. Donohue
Annals of Health Law and Life Sciences
Mr. Donohue discusses the history of nonprofit hospital conversions in the United States and analyzes the National Association of Attorneys General's Model Conversion Act. In addition, this article surveys conversion-related legislation of 17 states plus the District of Columbia. Finally, Mr. Donohue recommends the implementation of adequate safeguards to insure that nonprofit hospital assets are maximized and to insure that the subsequent use of conversion proceeds continues to fulfill the original charitable mission of the nonprofit hospital.
Table Of Contents, Annals Of Health Law
Table Of Contents, Annals Of Health Law
Annals of Health Law and Life Sciences
No abstract provided.
The "Knowingly And Willfully" Continuum Of The Anti-Kickback Statute's Scienter Requirement: Its Origins, Complexities, And Most Recent Judicial Developments, Douglas A. Blair
The "Knowingly And Willfully" Continuum Of The Anti-Kickback Statute's Scienter Requirement: Its Origins, Complexities, And Most Recent Judicial Developments, Douglas A. Blair
Annals of Health Law and Life Sciences
Mr. Blair analyzes the evolution of the Anti-Kickback Statute's scienter requirement. The article includes a historical review of the Anti-Kickback Statute and an in-depth discussion of three notable cases in this area, United States v. Greber, Hanlester Network v. Shalala, and United States v. Davis. The author concludes that without further guidance from either Congress or the Department of Health and Human Services, the split among circuits as to the proper definition of the Statute's scienter requirement makes the matter ripe for Supreme Court review.
Regulating Risk In A Managed Care Environment: Theory Vs. Practice, The Minnesota Experience, Barbara C. Colombo, Robert P. Webber
Regulating Risk In A Managed Care Environment: Theory Vs. Practice, The Minnesota Experience, Barbara C. Colombo, Robert P. Webber
Annals of Health Law and Life Sciences
Professor Colombo and Mr. Webber address the challenges that state regulators face in controlling the various forms of managed care as numerous hybrid risk-bearing entities emerge. This article also highlights the tensions between consumer protection and market competition and focuses on the experience of Minnesota regulators in this area.
The Police Power And The Regu0lation Of Medical Practice: A Historical Review And Guide For Medical Licensing Board Regulation Of Physicians In Erisa-Qualified Managed Care Organizations, Edward P. Richards
Annals of Health Law and Life Sciences
Professor Richards reviews the use of the state police power to regulate the medical profession. In addition, Professor Richards analyzes the role of physicians in managed care organizations, and describes how this role can be controlled through state police power regulation.
The Role Of The States In Combating Managed Care Fraud And Abuse, Joan H. Krause
The Role Of The States In Combating Managed Care Fraud And Abuse, Joan H. Krause
Annals of Health Law and Life Sciences
Professor Krause describes the weapons available to state regulators to address managed care fraud. Although many commentators have focused on recent federal anti-fraud efforts, Professor Krause argues that the states, through the use of a number of existing legal theories, have the most flexibility to combat fraudulent managed care practices. By using these targeted state-based efforts (in contrast to broader federal provisions), state regulators may be able to resolve problems more efficiently and with greater patient benefits.
Health Care Providers And Fraud Investigations: What Can You Do When The Goverment Changes The Rules In The Middle Of The Game?, Gordon E. Rountree Jr.
Health Care Providers And Fraud Investigations: What Can You Do When The Goverment Changes The Rules In The Middle Of The Game?, Gordon E. Rountree Jr.
Annals of Health Law and Life Sciences
Mr. Rountree addresses the federal government's multi-pronged attack on health care fraud and focuses on the options available to health care providers who are under investigation by the government. The article proposes three potential responses to fraud investigations, including: (1) lobbying the government for relief, (2) suing the government; or (3) waiting to defend or settle the fraud action. After analyzing each method, Mr. Rountree concludes that an aggressive lobbying campaign is likely to be the most successful of the three possible provider responses.
White Coat, Blue Collar: Physician Unionization And Managed Care, Ellen L. Luepke
White Coat, Blue Collar: Physician Unionization And Managed Care, Ellen L. Luepke
Annals of Health Law and Life Sciences
Ms. Luepke provides a historical review of the rise of the physician unionization movement in the United States. This article also examines the barriers faced by employed and independent physicians that prevent or limit their collective bargaining, and reviews the responses of the various organized medical societies to the physician unionization movement.
Table Of Contents, Annals Of Health Law
Table Of Contents, Annals Of Health Law
Annals of Health Law and Life Sciences
No abstract provided.
Federal Regulation Comes To Private Health Care Finnancing: The Group Health Insurance Provisions Of The Health Insurance Portability And Accountability Act Of 1996, Jack A. Rovner
Annals of Health Law and Life Sciences
Attorney Rovner presents a very detailed accounting of the impacts of the Health Insurance Portability and Accountability Act as it relates to group health insurance including provisions that concern pre-existing conditions, special enrollment rights, premium discrimination, maternity lengths of stay, parity for mental health benefits and small groups coverage. The article concludes with a discussion of the federalism question as it relates to regulation of private market health financing.
Foreword, John D. Blum
Regulating Managed Care Coverage: A New Direction For Health-Planning Agencies, Thaddeus J. Nodzenski
Regulating Managed Care Coverage: A New Direction For Health-Planning Agencies, Thaddeus J. Nodzenski
Annals of Health Law and Life Sciences
The article focuses on the role of health planning agencies in the context of managed care. The author argues that health planning agencies can be redirected toward assessment of managed care plans. Planning entities can be used to evaluate the viability of managed care markets taking into account societal, financial and medical considerations.
Managed Care At The Crossroads: Can Managed Care Organizations Survive Government Regulation?, Vickie Yates Brown, Barbara Reid Hartung
Managed Care At The Crossroads: Can Managed Care Organizations Survive Government Regulation?, Vickie Yates Brown, Barbara Reid Hartung
Annals of Health Law and Life Sciences
Attorneys Brown and Hartung provide a comprehensive overview of the development and structural components of managed health care plans. The article discusses the state regulatory controls affecting managed care including Patient Protection Acts. Mandated benefit provisions, any willing provider laws, and consumer access provisions. The article considers liability problems facing managed care organizations, in particular liabilities which arise from utilization and medical review discussions as well as gag clauses and financial incentive arrangements. The authors also review relevant federal regulatory initiatives.
Boards Of Directors Under Fire: An Examination Of Nonprofit Board Duties In The Health Care Environment, Naomi Ono
Annals of Health Law and Life Sciences
Attorney Ono presents a detailed discussion of fiduciary duty principles as applied to the directors of nonprofit health care corporations in the current health care environment. The article reviews general corporate responsibilities, the implication of the taxpayer's Bill of Rights 2, the care of In re Caremark International Inc. Derivative Litigation and particular issues faced by boards in nonprofit conversions.
Recent Chages To The Internal Revenue Code May Require Tax-Exempt Hospitals To Restructure Ownership Of Certain Activities, Joseph C. Mandarino
Recent Chages To The Internal Revenue Code May Require Tax-Exempt Hospitals To Restructure Ownership Of Certain Activities, Joseph C. Mandarino
Annals of Health Law and Life Sciences
This article by attorney Mandarino explores the implications of a 1997 change in the Internal Revenue Code affecting tax-exempt hospitals which run or operate for-profit businesses. The piece explores the application of prior law to hospital ownership of for profit ventures and continues on to review the implications of the 1997 amendment, particularly on existing structures. The article concludes with suggestions to avoid applications of the amended section.
Responsibilities Of Directors Of Not-For-Profit Corporations Faced With Sharing Control With Other Nonprofit Organizations In Health Industry Affiliations: A Commentary On Legal And Practical Realities, L. Edward Bryant Jr.
Annals of Health Law and Life Sciences
This article concerns the legal responsibilities of not-for-profit corporation directors in merges and affiliations with other not-for-profits. The article considers three sets of legal duties board members have, ancillary contractual obligations, madatory statutes and procedural laws, and contextual legal duties.
States, Congress, Or The Courts: Who Will Be First To Reform Erisa Remedies?, Curtis D. Rooney
States, Congress, Or The Courts: Who Will Be First To Reform Erisa Remedies?, Curtis D. Rooney
Annals of Health Law and Life Sciences
Curtis Rooney's article reviews the ERISA law and it relationship to managed care. The piece continues with a review of the relevant preermption provisions and a extentivsive discussion of related U.S. Supreme Court decisions. The author discusses malpractice and design liabilities. The article concludes with a discussion of reform initiatives directed toward the ERISA preemption and damage provisions.