Health Law and Policy Commons^™

Fighting Fraud With Two Hands Tied Behind Your Back: Health Care Fraud In The New Administrative State, Joan H. Krause

Journal of Law and Health

Although not directed at health care fraud, recent Supreme Court administrative law decisions—particularly Loper Bright Enterprises v. Raimondo and SEC v. Jarkesy—have destabilized the administrative foundations of federal health care fraud enforcement. The end of Chevron deference has shifted interpretive authority from agencies to courts, potentially increasing challenges to regulations and other administrative interpretations while encouraging agencies to rely more heavily on informal and less stable forms of guidance. Jarkesy further complicates enforcement by threatening the legality of civil monetary penalties, a common administrative penalty in health care fraud cases. Heightened judicial scrutiny, regulatory uncertainty, shifting executive priorities, …

From Premiums To Taxes: Financing Strategies For Single-Payer Health Care, David Gamage, James G. Kahn

Journal of Law and Health

Debates over financing single-payer health care reform proposals often discuss tax increases as costs without accounting for savings from the premiums and out-of-pocket payments that those taxes would replace. This Article evaluates the most important federal tax instruments that could be used to fund a national single-payer health care reform and then models three integrated approaches for financing such a reform that vary in their progressivity. Applying this to illustrative households, we find that each approach raise the revenues necessary to fund the reform while making the vast majority of low- and middle-income households better off, because their savings from …

Hope Springs Eternal: Phantom Visions For Deregulated Health Insurance, Mark A. Hall

Journal of Law and Health

Opponents of the Affordable Care Act (ACA) no longer seek explicitly to "repeal and replace" this widely popular law. Instead, opponents increasingly have turned to promoting deregulated alternatives like short-term health insurance, association health plans, and ministries that circumvent the ACA’s core requirement requirements, claiming that they offer better coverage options at substantially less cost. This essay explains, however, why comprehensive health insurance cannot remain affordable if the ACA's core regulatory structure is easily avoided.

The key insight is that, because health care costs are highly skewed across the population —such that the top 20% of spenders account for 80% …

Care After Insurance, Elenore Wade

Journal of Law and Health

This essay describes the theoretical and doctrinal problems caused by viewing healthcare and medicine through the framework of risk-based insurance. It also explains how the framework affects agency and institutional behavior in non-insurance medical payment programs and how it affects public political discourse on healthcare.

Betting On The Body: Private Equity Portfolio Funding Of Medical Malpractice Litigation And The Financialization Of Patient Justice, Barry J. Cohen

Journal of Law and Health

Portfolio-level third-party litigation funding in medical malpractice creates conflicts of interest that existing professional responsibility doctrine under Model Rule 1.7 was not designed to address. Unlike single-case consumer funding, which may improve access to justice, portfolio funding aggregates dozens or hundreds of malpractice claims into diversified investment vehicles, optimizing for internal rates of return on the portfolio instead of outcomes for individual plaintiffs. What follows, is the first sustained analysis of this gap.

Drawing on clinical and legal perspectives, the analysis distinguishes a single-case from portfolio funding and identifies four portfolio-specific conflicts under MRPC 1.7: the swing-for-the-fences problem, cross-subsidization, information …

Mental Illness, Probation, And Recidivism: Standardizing Uniform Mental Health Docket Legislation In Ohio, Holly Lloyd

Journal of Law and Health

The rise of Mental Illness diagnoses in the United States unique to the criminal justice system. Specifically in Ohio, individuals with mental illness diagnoses have increased within the criminal justice system leading to the implementation of the Mental Health Court Docket. The Mental Health Docket has led to a decrease in recidivism by providing Defendants with appropriate mental health treatment. Within Ohio there is no universal standard for individuals being admitted into the Docket which has led to inconsistencies throughout the State and restrictive clinical requirements like requiring a diagnosis with psychosis. These inconsistencies contribute to higher recidivism rates and …

Online Voting: Should Ohio Adopt Online Voting For Voters With Disabilities?, Audrey Mcconihe

Journal of Law and Health

This Note argues that Ohio should implement a limited online voting system for voters with disabilities in order to expand meaningful access to the voting while preserving election integrity. Drawing on the Americans with Disabilities Act, the Rehabilitation Act of 1973, the Voting Rights Act of 1965, and the Help America Vote Act, this Note contends that Ohio’s current absentee voting framework continues to impose substantial barriers on disabled voters by denying many individuals the ability to cast ballots privately, independently, and safely.

The Note examines how the COVID-19 pandemic exposed longstanding deficiencies in American voting infrastructure, particularly for disabled …

Roads To Regulation: A Discussion On Non-State Armed Groups' International Health Law Obligations, Eric Fogle

Journal of Law and Health

Non-state actors can look and operate like governments, yet without formal statehood, they exist in a regulatory gray area. Non state actors play an increasingly influential role in international law, yet they remain largely unregulated. This paper examines non-state actors as a class, with particular attention to non-State armed groups (NSAGs), and analyzes the regulatory gap they occupy specifically within international health law. The paper first surveys the rise, diversity, authority, and legitimacy of non-state actors in relation to States, highlighting their growing involvement in governance functions traditionally reserved for States. This paper then introduces the World Health Organization (WHO) …

Patent Pending: How The Current Patent Utility Requirement Hinders Biotechnological Innovation, Madison Drlik

Journal of Law and Health

The legal system is always playing catch up to adapt to new legal landscapes, doctrines, and technology; however, patent law needs help to compete with biotechnological research in the race towards innovation. Biotechnological research in the realm of human health and medicine often involves the use of therapeutic drugs. The field of healthcare biotechnology takes biological systems and processes and generates novel, creative solutions to a number of human health conditions. However, the translation process for a new drug, therapy, or process is long and expensive which requires investors to help the researchers and scientists move their creations from inception …

Fda's New Approval Plan For Covid-19 Vaccines: An Inquiry Of "Benefit" Rather Than The Statutory Scope Of "Safety, Purity, And Potency"?, Henry Yat-Shing Kwan

Journal of Law and Health

This article analyzes the FDA's proposed policy plan issued in May 2025 regarding the approval of Covid-19 boosters for different groups of persons. It offers two constructive recommendations that will help prevent constitutionality challenge on impermissible intrusion of the freedom of health.

The first is to avoid using the confusing term "benefit" but instead focus on the statutory parameters of "safety, purity, and potency." The affected group can make a strong case that their free choice of vaccination should not be deprived, as long as the vaccine qualifies for the statutory thresholds of being safe, pure, and potent. They are …

An Essay On Trailblazing With Service Animals Langer, Pilot, Bowie, And Izzie: Preserving Non-Partisan Public Health And The Law, Gary C. Norman

Journal of Law and Health

A direct correlation exists among humans, their animals, and human health and wellness. This article will focus concisely on law students with disabilities and lawyers with disabilities and how they can be empowered to be trailblazers while remaining healthy and well. Salutogenic Model should be optimized by lawyers with disabilities working at the intersection of animal law, disability law, and public health law. Service animals have positive and salubrious impacts upon their handlers in several ways, including psychosocial health and wellbeing. The Grand Architect (or in my Cherokee tradition, "great spirit") continuously partners me with complicated but magnificent dog partners …

Addressing Health-Related Social Needs With Innovative Healthcare Spending, Kelly Naranjo Ms Ccrc, Eric Rochman Mph, Allyson Schiff Ba, Dorella Walters Mpa, Andrea Zaldivar Ed.D, Ms, Anp

Journal of Law and Health

Key objectives: To address the social determinants of health domains "social and community context" and "neighborhood and built environment" via Medically Tailored Meals, a nutrition intervention that includes home delivery, medical nutrition therapy and education, and frozen medically tailored meals provided by the non-profit partner. This intervention targeted Medicaid members exhibiting high healthcare utilization in conjunction with each individual's risk of developing higher morbidity and mortality of existing disease due to co-existing food and nutrition insecurity. The populations served include people living with Type 2 Diabetes, Hypertension, Cardiovascular Disease, Cancer, HIV/AIDS, and End-Stage Renal Disease, among other conditions, whose burden …

Access To Healthcare For Irregular Migrants, Jessica Dykes

Journal of Law and Health

Access to Healthcare for Irregular Migrants is an assessment of the right to life, security of the person, and non-discrimination as viewed through the lens of Nell Toussaint's legal battle. It tells the compelling story of an irregular migrant's battle for access to health care. Highlighting a gap in the Canadian healthcare system, this piece raises valuable questions about why that gap exists. Toussaint's experiences with multiple levels of the legal system, both in Canada and internationally, are included. It tells the story from when Ms. Toussaint entered Canada to the present; wherein the matter remains before the court.

This …

Splitting Equality: Access To Gender-Affirming Care In The Fourth Circuit, Gilbert D. Jones

Journal of Law and Health

This Note critically examines the evolving legal landscape surrounding transgender individuals' access to gender-affirming care in the United States, focusing on two pivotal cases before the Fourth Circuit: Kadel v. Folwell (North Carolina) and Fain v. Crouch (West Virginia). These cases present a constitutional and statutory challenge to the exclusion of medically necessary gender-affirming care from state health plans, under Title VII of the Civil Rights Act of 1964 and the Equal Protection Clause of the Fourteenth Amendment. The Note contextualizes these lawsuits within a broader historical trajectory of transgender rights, highlighting legal and cultural milestones that have shaped access …

Amgen Enablement And Its Undue Burden On An Overburdened Biomedical Industry, Carter Chippi

Journal of Law and Health

This paper examines the Supreme Court decision in Amgen Inc. v. Sanofi and its profound impact on the patentability of biotechnology inventions, particularly biologic drugs. By virtually eliminating the possibility of claiming genera patents, the decision exacerbates existing challenges within the biologic sector, including high development costs and rigorous regulatory hurdles. The analysis sets forth the enablement requirement’s precedent, emphasizing historical case law and the unforeseen implications of setting a stringent standard for biotechnology patents. This paper further critiques suggested industry compromises, deeming them insufficient to address the ramifications of Amgen, and proposes legislative intervention. Options include granting biologics …

The Ultra (And Nearly Ultra) Locality Rules Persist! Why Continue To Ignore Modern Medicine And Contort The Standard Of Care?, Marc D. Ginsberg

Journal of Law and Health

The use of the locality rule to define or modify the medical standard of care is inconsistent with modern medicine. Nevertheless, various states in the U.S. continue to adhere to a locality rule. This paper revisits this topic, about which I have previously written, by focusing on Idaho, Nebraska, Tennessee and Arkansas. The paper concludes by suggesting that locality rules should be eliminated in favor of a national standard of care.

Cannabis In The Clink: An Argument In Favor Of Medical Marijuana For Disabled Inmates, Sophia Dechurch

Journal of Law and Health

In recent decades, medical marijuana programs have become commonplace, and most states in the United States of America are ready to accept marijuana as a natural alternative to treat symptoms of certain conditions such as chronic pain, cancer, mental illness, multiple sclerosis (MS), HIV/AIDS, and substance use disorder; as such, medical marijuana is readily accessible to those who have a qualifying diagnosis – the exception being those who are incarcerated. Although disability, substance abuse, and mental illness are prevalent among those under state supervision, these individuals are effectively prohibited from enjoying the benefits of medical marijuana. This Note will provide …

Rest In The Mourning: Navigating Assisted Suicide And Autonomy, Jada Rhome

Journal of Law and Health

Life, in all its diversity, has always been revered for its beauty, be it in the myriad opportunities it presents, the relationships we forge, or the cyclical changes that shape our journey. Yet, life’s harsh winters, those prolonged periods of suffering, often push the boundaries of endurance, prompting the question: Should we insist on perseverance when the hope of relief seems distant? This paper aims to explore this very question in the context of assisted suicide. This paper delves into the intricate ethical landscape of assisted suicide, navigating the complex interplay between autonomy, dignity, and the sanctity of life. At …

Cracking The Façade: Analyzing Ohio's "Don't Say Gay" Legislation As Disguised Discrimination Under The First And Fourteenth Amendments, Sydni L. Porter

Journal of Law and Health

The Ohio State Legislature is among the growing nationwide trend in attacking LGBTQ+ rights. Chief among these is Ohio House Bill 8, which claims to limit the types of content children encounter in schools. While the drafters cite this noble intent, the bill's actual impact further harms queer students and teachers, who already bear heavier mental health burdens due to such legislation and its societal implications. This type of legislation recently originated in Florida, where it was signed into law by Governor Ron DeSantis in 2022 and garnered national media attention. As Ohio Governor Mike DeWine signed a near-identical bill …

Transcript: Structural Racism, The Healthcare System And Health Justice, Ruquaiijah Yearby

Journal of Law and Health

The following is a transcript from Racial Disparities and Outcomes presented at Cleveland State University College of Law by the Journal of Law and Health on Friday, February 9, 2024. This transcript has been lightly edited for clarity and to reflect updates in the relevant law since the time of transcription.

Transcript: Rethinking Federalism In Health Care, Allison Whelan

Journal of Law and Health

The following is a transcript from Racial Disparities and Outcomes presented at Cleveland State University College of Law by the Journal of Law and Health on Friday, February 9, 2024. This transcript has been lightly edited for clarity and to reflect updates in the relevant law since the time of transcription.

Unshackled: Why Eliminating Health Disparities Requires That Our Criminal Justice System Set Incarcerated Mothers And Their Developing Children Free, Angela Dixon

Journal of Law and Health

Incarceration of pregnant nonviolent offenders takes not only the pregnant mother captive but also her unborn child. Kept in unnecessary captivity, these innocent children may experience adverse childhood experiences (“ACES”) or lifelong damage to their physical and mental health. The experiences may be the same for children born already to the mother, as they endure the suffering of parental separation during the mother’s absence. In terms of racial health disparities, such captivity presents at least a triple threat—harm to the health of the mother, harm to the health of the unborn fetus, and harm to the health of children born …

Transcript: Patient Reported Outcome Measures, Dr. Sharona Hoffman

Journal of Law and Health

The following is a transcript from Racial Disparities and Outcomes presented at Cleveland State University College of Law by the Journal of Law and Health on Friday, February 9, 2024. This transcript has been lightly edited for clarity and to reflect updates in the relevant law since the time of transcription.

Countering Workplace Wellness Bias Through Wellness-Legal Partnerships, Barbara J. Zabawa Jd, Mph

Journal of Law and Health

In the current United States economy, wellness is predominantly marketed to society’s privileged individuals, catering to a mostly white and high-income clientele. When marginalized communities encounter wellness services, such as in the workplace, they are faced with an implicitly biased industry. These biases include an emphasis on individual behavior change without considering social determinants of health (SDOH), cultural appropriation of wellness activities for capitalistic gain, use of biased health measures like Body-Mass Index (BMI), and constant images of and expectations of achieving a stereotypical healthy body. The legal community must wake up to these biases and advocate for more equitable …

Medical Consensus On Gender Affirming Care's Critical Impact On Incarcerated Black Transgender Women, John Parsi

Journal of Law and Health

In Kosilek v. Spencer the U.S. Court of Appeals for the First Circuit adopted The World Professional Association of Transgender Health Standards of Care (WPATH SOC) as medical consensus on gender affirming care and held that Michelle Kosilek could access gender affirming care but that she did not meet the criteria for gender affirming surgery. In Gibson v. Collier the U.S. Court of Appeals for the Fifth Circuit with a sparse record and no expert testimony denied Vanessa Lynn Gibson access to gender affirming surgery and incorrectly claimed that Kosilek did not support the WPATH SOC as representing the medical …

Covid-19 And Access To Healthcare At The Crossing Of Race, Poverty, And Rurality, Shavonnie R. Carthens

Journal of Law and Health

Black Americans make up 7.7 percent of the rural population in the United States. During the COVID-19 pandemic many in this population found themselves at a unique intersection of inequity - being Black, poor, and residing in a rural area. Poverty is a known contributor to negative health outcomes and is a risk factor for death from coronavirus infection. The association between race and poverty, when examining infectivity and mortality rates of COVID-19, have disproportionately devastated Black Americans and other minorities. Further, research indicates the presence of a general “rural mortality penalty” wherein rural Black communities have higher death rates …

Developing Thick Skin: Pediatric Eczema In Vulnerable Communities And Fda Regulation Of Cosmetic Products, Abayomi Jones Md, Jd

Journal of Law and Health

Eczema is a common yet serious inflammatory skin condition affecting millions of children in the United States. Dark skin and/or African-American ethnicity are risk factors for increased eczema severity, most likely due to systemic racism expressed as lower socioeconomic status, increased environmental toxin exposure, decreased access to adequate medical care, and infrequent implementation of early intervention practices. Skin-directed management of eczema for caregivers is critically important for improving clinical outcomes of children with eczema. Skin-directed management of eczema includes avoidance of allergens and appropriate moisturization of skin, which warrants evaluation of cosmetic products like lotions, creams and oils essential for …

Secrets Clutched In A Dead Hand: Rethinking Posthumous Psychotherapist-Patient Privilege In The Light Of Reason And Experience With Other Evidentiary Privileges, Jared S. Sunshine

Journal of Law and Health

Attorney-client privilege was held by the Supreme Court to extend beyond death in 1996, albeit only ratifying centuries of accepted practice in the lower courts and England before them. But with the lawyer’s client dead, the natural outcome of such a rule is that privilege—the legal enforcement of secrecy—will persist forever, for only the dead client could ever have waived and thus end it. Perpetuity is not traditionally favored by the law for good reason, and yet a long and broad line of precedent endorses its application to privilege. The recent emergence of a novel species of privilege for psychotherapy, …

California V. Texas: Avoiding An Antidemocratic Outcome, Jon Lucas

Journal of Law and Health

The Affordable Care Act (“ACA”) contains a section titled “Requirement to Maintain Essential Minimum Coverage.” Colloquially known as the Individual Mandate, this section of the Act initially established a monetary penalty for anyone who did not maintain health insurance in a given tax year. But with the passage of the Tax Cuts and Jobs Act, the monetary penalty was reset to zero, inducing opponents of the ACA to mount a legal challenge over the Individual Mandate’s constitutionality. As the third major legal challenge to the ACA, California v. Texas saw the Supreme Court punt on the merits and instead decide …

Privileges, Immunities, And Affirmative Action In Medical Education, Gregory Curfman

Journal of Law and Health

In Students for Fair Admissions v. President & Fellows of Harvard College and Students for Fair Admissions v. University of North Carolina, the Supreme Court ruled that affirmative action in university admissions, in which an applicant of a particular race or ethnicity receives a plus factor, is unconstitutional. This ruling was based on both the Equal Protection Clause of the Fourteenth Amendment and Title VI of the Civil Rights Act of 1964. This article argues that a more natural fit as the basis for constitutional analysis would be a different clause in the Fourteenth Amendment, the Privileges or Immunities …