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Full-Text Articles in Health Law and Policy
A Look Back At The Year In Health Law, Jeffrey R. Bennett
A Look Back At The Year In Health Law, Jeffrey R. Bennett
Annals of Health Law and Life Sciences
The Bennett article takes us back to 1997 and reviews key legislators, regulations and judicial developments in Medicare, antitrust, tax and ERISA, all of which greatly impact the practice of health law.
Table Of Contents, Annals Of Health Law
Table Of Contents, Annals Of Health Law
Annals of Health Law and Life Sciences
No abstract provided.
Foreword, John D. Blum
The Brave New World Of Health Care Compliance Programs, Thomas E. Bartrum, L. Edward Bryant Jr.
The Brave New World Of Health Care Compliance Programs, Thomas E. Bartrum, L. Edward Bryant Jr.
Annals of Health Law and Life Sciences
The need for corporate compliance programs in health care delivery systems is ever increasing. This article identifies the key items a good program should contain, and addresses issues raised by the existence of a program as well as its implementation.
Interpreting The 1996 Federal Antitrust Guidelines For Physician Joint Venture Networks, Edward Hirshfeld
Interpreting The 1996 Federal Antitrust Guidelines For Physician Joint Venture Networks, Edward Hirshfeld
Annals of Health Law and Life Sciences
The Statements of Antitrust Enforcement Policy in Health Care, issued by the FTC and the DOJ, dramatically change how the agencies evaluate physician joint venture networks. This article analyzes the Statements, providing useful guidance to the health lawyer.
Mixing Oil And Water: The Government's Mistaken Use Of The Medicare Anti-Kickback Statute In False Claims Act Prosecutions, Robert Salcido
Mixing Oil And Water: The Government's Mistaken Use Of The Medicare Anti-Kickback Statute In False Claims Act Prosecutions, Robert Salcido
Annals of Health Law and Life Sciences
In 1996, billing integrity generated a great deal of debate and litigation in the health care arena. Significantly, the federal government views a violation of the Anti-Kickback Act as a basis for a False Claims Act action. While federal courts are split on the issue, the author strongly contends that using the False Claims Act to do what the Anti-Kickback Act was intended to do is inappropriate, given Congress' intention in enacting each legislation.
The Government's Use Of The Civil False Claims Act To Enforce Standards Of Quality Of Care: Integrity Or The Heavy Hand Of The 800-Pound Gorilla, Michael M. Mustokoff, Jody A. Werner, Michael S. Yecies
The Government's Use Of The Civil False Claims Act To Enforce Standards Of Quality Of Care: Integrity Or The Heavy Hand Of The 800-Pound Gorilla, Michael M. Mustokoff, Jody A. Werner, Michael S. Yecies
Annals of Health Law and Life Sciences
Fraud and abuse issues abound in health care. A new, rather unique assertion is that submitting a bill for health care that is inadequate constitutes a violation of the Civil False Claims Act. The authors contend that there are more effective and appropriate ways to address poor quality of care, and that using the False Claims Act in this matter is like fitting a square peg in a round hole.
Directors' Duty Obtain A Fair Price In The Conversion Of Nonprofit Hospitals, Eric S. Tower
Directors' Duty Obtain A Fair Price In The Conversion Of Nonprofit Hospitals, Eric S. Tower
Annals of Health Law and Life Sciences
Boards of Directors of tax-exempt hospitals are increasingly struggling with whether to convert their facilities to for-profit status. Other than the traditional duties of loyalty and fair dealings imposed upon directors, there is currently little guidance to assure that boards obtain a fair price for the hospital in such conversions. The author provides recommendations to assure proper valuation.
Post-Decision Diagnosis: Medical Device Preemption Alive And Mostly Well After Medtronic, Inc. V. Lohr, Scott W. Sayler, Steven M. Thomas
Post-Decision Diagnosis: Medical Device Preemption Alive And Mostly Well After Medtronic, Inc. V. Lohr, Scott W. Sayler, Steven M. Thomas
Annals of Health Law and Life Sciences
In Medtronic, Inc. v. Lohr, the United States Supreme Court, in a five-to-four split, held that the Medical Device Amendments of 1976 did not preempt state tort claims against a pacemaker manufacturer. A careful reading of the factually specific holding of this case suggests that manufacturers of medical devices distributed pursuant to premarket approval requirements and investigational device exemption can still successfully raise preemption as a defense to state common law tort claims.
To Resuscitate Or Not ... In The Operating Room: The Need For Hospital Policies For Surgeons Regarding Dnr Orders, Vassyl A. Lonchyna
To Resuscitate Or Not ... In The Operating Room: The Need For Hospital Policies For Surgeons Regarding Dnr Orders, Vassyl A. Lonchyna
Annals of Health Law and Life Sciences
As more Americans have become aware of end-of-life planning, health care professionals are faced with more "Do Not Resuscitate" orders. A patient with a terminal condition who has signed such an order may enter the operating room for a surgical procedure; few hospitals have developed protocols to assist the medical staff. In most hospitals, it is unclear whether the medical staff should honor the "DNR" or follow the traditional resuscitation protocol of the operating room.
Health Care Fraud And Abuse: New Weapons, New Penalties, And New Fears For Providers Created By The Health Insurance Protability And Accountability Act Of 1996 ("Hipaa"), Colleen M. Faddick
Health Care Fraud And Abuse: New Weapons, New Penalties, And New Fears For Providers Created By The Health Insurance Protability And Accountability Act Of 1996 ("Hipaa"), Colleen M. Faddick
Annals of Health Law and Life Sciences
The Health Insurance Portability and Accountability Act of 1996 may well be the most significant increase ever in the federal government's health care fraud and abuse enforcement authority. This new authority coupled with increased scrutiny of the health care industry generally creates a compelling incentive for health care facilities to develop corporate compliance programs.
The Role Of The Federal Government In Ensuring Quality Of Care In Long-Term Care Facilities, David R. Hoffman
The Role Of The Federal Government In Ensuring Quality Of Care In Long-Term Care Facilities, David R. Hoffman
Annals of Health Law and Life Sciences
Quality of care is a concept most important to our vulnerable populations, including the elderly. When the government pays for nursing care for the elderly, it expects that it is paying for quality care. When the quality is substandard, as it was with Tucker House II, the government can and will use the False Claims Act to recover monies paid.
Rights Of The Terminally Ill Patient, John Hodgson
Rights Of The Terminally Ill Patient, John Hodgson
Annals of Health Law and Life Sciences
An examination of the rights in the United Kingdom of terminally ill patients, both competent and incompetent, shows the struggle courts face.
Table Of Contents, Annals Of Health Law
Table Of Contents, Annals Of Health Law
Annals of Health Law and Life Sciences
No abstract provided.
Foreword, John D. Blum
The Marshfield Clinic Case: The Sound Of A Broken Record, Kevin Mcdonald
The Marshfield Clinic Case: The Sound Of A Broken Record, Kevin Mcdonald
Annals of Health Law and Life Sciences
Defense counsel for Marshfield Clinic explains why he believes the trial court record was inadequate to support the plaintiffs' claims and offers an insider's perspective on Judge Posner's opinion.
Investigational Treatments: Coverage, Controversy, And Consensus, Mary Ader
Investigational Treatments: Coverage, Controversy, And Consensus, Mary Ader
Annals of Health Law and Life Sciences
Medical and legal controversies surrounding payment for investigative treatments abound. The debate should be moved from the legal to the medical arena, and health plans should support the quest for scientific evidence by contributing to well-conceived clinical trials in appropriate circumstances.
The Embryonic Self-Evaluative Privilege: A Primer For Health Care Lawyers, Thomas F. O'Neil Iii, Adam H. Charnes
The Embryonic Self-Evaluative Privilege: A Primer For Health Care Lawyers, Thomas F. O'Neil Iii, Adam H. Charnes
Annals of Health Law and Life Sciences
In an era in which health care fraud is a top law enforcement priority, internal audits by health care entities are increasingly important. While the self-evaluative privilege, intended to encourage voluntary, confidential self-analysis, offers some protection of such sommunications, its scope is restricted.
Beyond Baby M: International Perspectives On Gestational Surrogacy And The Demise Of The Unitary Biological Mother, Todd M. Krim
Beyond Baby M: International Perspectives On Gestational Surrogacy And The Demise Of The Unitary Biological Mother, Todd M. Krim
Annals of Health Law and Life Sciences
Gestational surrogacy raises a host of legal and ethical issues. A review of state, federal, and international response, both legislative and judicial, to these issues reveals that the United States would benefit from comprehensive federal legislation regulating the reproductive technology field.
The Captive Medical Malpractice Insurance Company Alternative, James A. Christopherson
The Captive Medical Malpractice Insurance Company Alternative, James A. Christopherson
Annals of Health Law and Life Sciences
Health care providers, driven by skyrocketing premiums, are seeking alternatives to conventional medical malpractice insurance. Captive malpractice insurance companies are an increasingly popular choice, but providers should consider tax, regulatory, and other consequences before adopting this option.
Legal And Political Issues Facing Telemedicine, Kathleen M. Vyborny
Legal And Political Issues Facing Telemedicine, Kathleen M. Vyborny
Annals of Health Law and Life Sciences
The emergence of telemedicine-medical diagnosis and treatment via telecommunications-offers the promise of reduced cost, improved patient outcomes, and greater access to quality medical care. But a variety of legal barriers to telemedicine must be addressed to assure its effective use.
Causation Issues In Medical Malpractice: A United Kingdom Perspective, Marc S. Stauch
Causation Issues In Medical Malpractice: A United Kingdom Perspective, Marc S. Stauch
Annals of Health Law and Life Sciences
In the United Kingdom, the most difficult aspect of proving a medical malpractice claim may be establishing causation-the link between the medical professional's breach of duty and the patient's damages. Because the traditional "but for" test unfairly burdens the plaintiff, a rule such as the "loss of chance" doctrine would be more equitable.
Equicare: A Model For Quality Health Care And Consumer Choice In State Health System Reform, Lois Snyder
Equicare: A Model For Quality Health Care And Consumer Choice In State Health System Reform, Lois Snyder
Annals of Health Law and Life Sciences
Equicare is a proposed market-based, proconsumer approach to state health care reform. While it was developed for a gubernatorial primary race in Pennsylvania, it addresses problems that arise in every state, including incomplete access, inadequacies in public programs, and inefficiencies in care.
National Repositories Of Information: A Comparison Of The National Practitioner Data Bank In The United States And The National Confidential Enquiry Into Perioperative Deaths In The United Kingdom, Gail Daubert
Annals of Health Law and Life Sciences
Both the United States and the United Kingdom have created national data banks intended to improve the quality of medical care by identifying and reducing medical errors. A comparison of the United States' National Practitioner Data Bank to the United Kingdom's National Confidential Enquiry into Perioperative Deaths sheds insight on how well these goals are being met.
Physician Recruitment After Hermann Hospital, Robert C. Louthian Iii, Elizabeth M. Mills
Physician Recruitment After Hermann Hospital, Robert C. Louthian Iii, Elizabeth M. Mills
Annals of Health Law and Life Sciences
The state of physician recruitment changed after the Internal Revenue Service required Hermann Hospital to publish its closing agreement with the IRS. The closing agreement released the long-awaited IRS "Hospital Physician Recruitment Guidelines." The IRS' recently proposed revenue ruling provides additional insight on acceptable physician recruitment practices as well.
The Government's Best Offense Is Deference: The Decision Of The Supreme Court In Shalala V. Guernsey Memorial Hospital, Robert L. Roth
The Government's Best Offense Is Deference: The Decision Of The Supreme Court In Shalala V. Guernsey Memorial Hospital, Robert L. Roth
Annals of Health Law and Life Sciences
The United States Supreme Court agreed with the Secretary of Health and Human Services that Guernsey Memorial Hospital's advance refunding transaction costs would be subject to a medicare reimbursement policy that is not based upon generally accepted accounting principles. According to the sharp dissent in this case, this policy, set forth in a manual provision, contradicts federal regulations.
Table Of Contents, Annals Of Health Law
Table Of Contents, Annals Of Health Law
Annals of Health Law and Life Sciences
No abstract provided.
Foreword, Annals Of Health Law
Foreword, Annals Of Health Law
Annals of Health Law and Life Sciences
No abstract provided.
The False Claims Act: An Old Weapon With New Firepower Is Aimed At Health Care Fraud, David J. Ryan
The False Claims Act: An Old Weapon With New Firepower Is Aimed At Health Care Fraud, David J. Ryan
Annals of Health Law and Life Sciences
The ancestors of the wild west bounty hunters have found a new group of targets in the health profession. Armed with a qui tam action and the tenacity to work with the government, purveyors of false claims information can reap hefty financial rewards.
Preferred Provider Organization Structures And Agreements, James C. Dechene
Preferred Provider Organization Structures And Agreements, James C. Dechene
Annals of Health Law and Life Sciences
Preferred provider organizations can be created with both positive and negative consequences. Certain structures meet certain needs, and many contract terms can benefit the parties or create pitfalls.