Health Law and Policy Commons^™

Improving Hipaa Enforcement And Protecting Patient Privacy In A Digital Healthcare Environment, Roger Hsieh

Loyola University Chicago Law Journal

Electronic medical records (“EMRs”) have helped healthcare organizations improve patient care, but EMRs are susceptible to exposing the confidentiality of patients’ medical records to identity thieves and members of the general public. The federal enforcement of patient privacy law—notably the Health Insurance Portability and Accountability Act (“HIPAA”), which was designed to deter and punish breaches of patient privacy—has failed to keep pace with new privacy risks posed by healthcare technology. Although federal legislation now allows state Attorneys General to file suit under HIPAA, for reasons explained in this Article, they too will not enforce HIPAA effectively. Because institutional enforcement of …

Beyond Payment And Delivery Reform: The Individual Mandate’S Cost-Control Potential, Abigail R. Moncrieff, Manisha Padi

Law Faculty Articles and Essays

Obamacare's individual mandate, minimum coverage requirements, elimination of cost-sharing for preventive care, and minimum medical loss ratios work together to decrease patients' decision costs, steering patients to particular choices that Congress deemed most efficient. If those regulations succeed in improving the efficiency of patients' healthcare and insurance choices, then the resulting demand-side forces can help to decrease prices. This brief Essay does not attempt to evaluate the regulations' success; it merely highlights the cost-control implications of Obamcare's demand-side measures, noting that discussions of cost control should not focus exclusively on the statute's supply-side effects.

It's A Mistake: Insurer Cost Cutting, Insurer Liability, And The Lack Of Erisa Preemption Within The Individual Exchanges, Christopher Smith

Cleveland State Law Review

In today’s society, most people receive their health insurance through their employers. If their employment-based insurer engages in cost cutting that leads to patient injury, Employee Retirement Income Security Act of 1974 (“ERISA”) preemption means that these people have no state tort-based recourse against their insurers. ERISA is a federal statute that regulates employee benefit plans, and the Supreme Court has interpreted the ERISA statute to preempt most beneficiary state tort claims against an employment-based insurer. In other words, even if the insurer, and not the doctor, caused the patient’s harm, the patient with employment-based insurance can only sue their …

Health And Human Rights, Jonathan Todres

Faculty Publications By Year

No abstract provided.

Ethics Consultations And Conflict Engagement In Health Care, Charity Scott

Faculty Publications By Year

This article explores the intersection of two professional fields - bioethics and clinical ethics consultation in health care on one hand, and alternative dispute resolution ("ADR") and conflict management on the other - which until recent years remained relatively unknown to each other. It marries the literatures and lessons of these two fields in order to promote the quality of ethics consultations in hospitals and other health care organizations. * Increasingly, health care ethics committees and consultants acknowledge the need to employ the frameworks, approaches, and tools of good conflict management to do their work effectively. Similarly, conflict specialists and …

Further Standing Lessons, Heather Elliott

Indiana Law Journal

Professor Elliott wrote a piece for the Indiana Law Journal in 2012 (available here). In this article, she updates her analysis and explores the implications of both the health-care and marriage equality cases on the Court’s standing doctrine.

The Case For Mandatory Training On Screening For Domestic Violence In The Wake Of The Affordable Care Act, Nat Stern, Karen Oehme

Scholarly Publications

No abstract provided.

The Right To Safe Water And Crown-Aboriginal Fiduciary Law: Litigating A Resolution To The Public Health Hazards Of On-Reserve Water Problems, Constance Macintosh

Articles, Book Chapters, & Popular Press

Canada is at a crossroads. The gap between our national self-image as a country that respects human rights and the reality of socio-economic inequality and exclusion demands a re-engagement with the international human rights project and a recommitment to the values of social justice and equality affirmed in the early years of the Canadian Charter of Rights and Freedoms. This book sketches a blueprint for reconceiving and retrieving social rights in diverse spheres of human rights practice in Canada, both political and legal. Leading academics and activists explore how the Charter and administrative decision making should protect social rights …

The Making Of A Myth: Unreliable Data On Access To Palliative Care In Canada, Jocelyn Downie, Georgia Lloyd-Smith

Articles, Book Chapters, & Popular Press

Assisted death is now the subject of conversation in the media, in public meetings, and around kitchen tables across the country. A frequent part of many conversations about assisted death law reform is access to quality palliative care in Canada. Throughout the literature and other forms of media, the claim is made that only 16-30% of Canadians have access to palliative care (or, its derivative, 70% are without access). The “16-30%” claim has been widely accepted as a fact. But is it, in fact, true? We are driven to the conclusion that the oft-repeated claim that only 16-30% of Canadians …

Achieving National Altruistic Self-Sufficiency In Human Eggs For Third-Party Reproduction In Canada, Jocelyn Downie

Articles, Book Chapters, & Popular Press

To avoid the commercialization of reproduction, the Canadian Assisted Human Reproduction Act (AHR Act 2004) prohibits the purchase of human eggs. We endorse this legal prohibition and moreover believe that this facet of the law should not be allowed to have as an unintended consequence an increase in transnational trade in human eggs. In an effort to avoid this consequence, and to be consistent with the AHR Act, we advocate a system of national altruistic self-sufficiency. This article briefly outlines a number of strategies to increase the domestic altruistic supply of third-party eggs and decrease the domestic demand for third-party …

In Defence Of Consent And Capacity Boards For End-Of-Life Care, Jocelyn Downie, Michael Hadskis

Articles, Book Chapters, & Popular Press

In Cuthbertson v. Rasouli, the Supreme Court of Canada (SCC) found that, in Ontario, it is the Consent and Capacity Board (CCB) and not the courts per se who will resolve conflicts between substitute decision-makers (SDMs) and health practitioners regarding the withdrawal of lifesustaining treatment from incapable patients. This finding was based on the SCC’s interpretation of the Ontario Health Care Consent Act (HCCA). Hawryluck et al. express concern about the SCC’s determination that the CCB is charged with resolving such conflicts since, in their view, this body is ill-equipped to fulfill this role. Instead, they take the position that …

Cutting The Gordian Knot Of Futility: A Case For Law Reform On Unilateral Withholding And Withdrawal Of Potentially Life-Sustaining Treatment, Jocelyn Downie, Lindy Willmott, Ben White

Articles, Book Chapters, & Popular Press

In this paper, we propose law reform with respect to the unilateral withholding or withdrawal of potentially life-sustaining treatment in Australia and New Zealand. That is, where a doctor withholds or withdraws potentially life-sustaining treatment without consent from a patient or a patient’s substitute decision-maker (where the patient lacks capacity), or authorisation from a court or tribunal, or by operation of a statute or justifiable government or institutional policy. Our proposal is grounded in the core values that do (or should) underpin a regulatory framework on an issue such as this; these values are drawn from existing commitments made by …

The Conflict Of Visions In Nfib V. Sebelius, Jonathan H. Adler

Faculty Publications

In 2010, few anticipated the fate of healthcare reform would rest with the Supreme Court. Yet National Federation of Independent Business v. Sebelius [hereinafter NFIB] emerged as a watershed case that could remake the constitutional landscape. NFIB presented a conflict between two constitutional visions of federal power and the role of the courts in policing such limits--an unconstrained vision, under which limits on federal power are enforced primarily through the political process, and a constrained vision, under which constitutional limits on federal power are enforced by the courts. The contrasting views of the constitutionality of the individual mandate and …

Sovereignty, Citizenship, And Public Health In The United States, Polly J. Price

Faculty Articles

Sovereign boundaries, state borders, and distinctions between citizens and non-citizens undermine public health in the United States in a number of ways. For historical reasons, we are prone to view immigration and public health as separate interests, but they are in fact convergent. Historically, federal authority over immigration alleviated costs otherwise borne by state and local governments. Today, however, states are primarily responsible for the prevention and control of communicable disease acquired outside U.S. borders. The federal and state governments confront a stark division of authority with respect to non-citizens: The federal government decides which non-citizens to admit into the …

Uncovering The Silent Victims Of The American Medical Liability System, Joanna Shepherd

Faculty Articles

A frequently overlooked problem with the current medical liability system is the vast number of medical errors that go uncompensated. Although studies indicate that 1% of hospital patients are victims of medical negligence, fewer than 2% of these injured patients file claims. In this Article, I explain that many victims of medical malpractice do not file claims because they are unable to find attorneys willing to take their cases.

I conducted the first national survey of attorneys to explore medical malpractice victims' access to the civil justice system. The results from the survey indicate that the economic reality of litigation …

Selective Contracting In Prescription Drugs: The Benefits Of Pharmacy Networks, Joanna Shepherd

Faculty Articles

Selective contracting in health care involves contractual arrangements among insurers and health care providers that give covered individuals a financial incentive to obtain health care from a limited panel of providers. Although selective contracting has been an important strategy of health insurance plans for decades, it has only recently expanded to prescription drug coverage. Drug plans now create pharmacy networks that channel customers to in-network pharmacies. Pharmacies compete to be part of the networks by offering discounts on the drugs they sell to covered customers and drug plans. Although networks can lower prescription drug costs for drug plans and consumers, …

Veterans Treatment Court: A Hand Up Rather Than Lock Up, Tabatha Renz

Richmond Public Interest Law Review

There has been a gradual national shift toward rehabilitation within the justice system. This has been especially important for veterans who make up only 8% of the total population, but account for 10% of those with criminal records. Recognizing that the traditional justice system is not equipped to handle cases of individuals whose underlying cause of offense is combat trauma, there has been a call to expand the Veterans Treatment Court ("VTC") program as an alternative for offenders who are veterans of the armed forces. This issue has been compounded by over a decade of war in Iraq and Afghanistan, …

An Analysis Of The Political And Legal Debates Concerning Medicaid Expansion In Virginia, Rick Mayes Ph.D, Benjamin Paul

Richmond Public Interest Law Review

The Supreme Court's historic June 2012 ruling regarding the Affordable Care Act (ACA) in National Federation of Independent Business v. Sebelius set the stage for a massive federalism battle over Medicaid expansion in the United States. The original language of the Act was intended to nationalize Medicaid by having every state expand their program's eligibility to all individuals up to 138% of the federal poverty level. This would have significantly reshaped Medicaid, a joint federal-state health insurance program, into a universal entitlement for all low-income citizens. Currently, Medicaid eligibility varies dramatically from state to state. The Court held that the …

Hiv Infrastructure Study Columbia, Sc, Susan S. Reif, Elena Wilson, Carolyn Mcallaster

Faculty Scholarship

No abstract provided.

Discovery Of Medical Records In Oklahoma State Courts, Charles W. Adams

Articles, Chapters in Books and Other Contributions to Scholarly Works

No abstract provided.

Curing The Disobedient Patient: Medication Adherence Programs As Pharmaceutical Marketing Tools, Matt Lamkin, Carl Elliott

Articles, Chapters in Books and Other Contributions to Scholarly Works

No abstract provided.

Rationalizing Home And Community-Based Services Under Medicaid, Laura Hermer

Faculty Scholarship

This article examines efforts states are making to expand access to community-based services for elderly and disabled Medicaid beneficiaries and suggests several options that might improve such access nationally. Like much of Medicaid, Medicaid long term services and supports (LTSS) have developed through a complex process of accretion. Policymakers appear only rarely to have considered an overarching view of such services and the needs of those who require them. Rationalizing Medicaid LTSS will accordingly require not only additions but also substantial pruning, and may even warrant a reconsideration of who should have ultimate authority to develop and direct such services. …

Context Matters: Disability, The End Of Life, And Why The Conversation Is Still So Difficult, Alicia Ouellette

NYLS Law Review

No abstract provided.

Should All Drugs Be Patentable?: A Comparative Perspective, Cynthia M. Ho

Faculty Publications & Other Works

Although there has been substantial discussion of the proper scope of patentable subject matter in recent years, drugs have been overlooked. This Article begins to address that gap with a comparative perspective. In particular, this Article considers what is permissible under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), as well as how India and Canada have utilized TRIPS flexibilities in different ways to properly reward developers of valuable new drugs, while also considering the social harm of higher prices beyond an initial patent term on drugs.

This Article brings valuable insight into this area at a critical …

Drugged Out: How Cognitive Bias Hurts Drug Innovation, Cynthia M. Ho

Faculty Publications & Other Works

No abstract provided.

Sex, Science, And The Age Of Anxiety, Linda C. Fentiman

Elisabeth Haub School of Law Faculty Publications

This article examines the question of whether the HPV vaccine should be mandated (for girls and/or boys) in the context of declining rates of childhood immunization, and the potential threat to public health that this decline poses. The article addresses two interconnected legal issues: first, is mandating vaccines to prevent the spread of disease constitutional under substantive due process and equal protection principles, and second, should parents be permitted to “opt out” of mandatory vaccination on their children’s behalf, either for all vaccines or those which prevent particular diseases. The article addresses these issues in the context of America’s growing …

Asbestos Lawsuits In Russia: Bring One If You Can, Anna Linetskaya

Cardozo Journal of International and Comparative Law

The note examines the challenges faced by asbestos victims in Russia in seeking legal redress, highlighting the barriers posed by the country's legal system, lack of regulatory oversight, and the dominance of the asbestos industry. It argues that despite the existence of tort law as a potential avenue for relief, numerous structural and procedural obstacles deter victims from pursuing claims, underscoring the need for legal reforms to improve access to justice.

Taxation Of Series Llcs In Texas: Bigger Isn't Always Better In The Lone Star State., Alyson Outenreath

St. Mary's Law Journal

Series Limited Liability Companies (series LLCs) are not yet widely popular as an entity of choice; but just as it took many years for traditional LLCs to become widely used, there could also come a day when series LLCs are the “go-to” entity of choice. One development in the law that will aid in this process is greater certainty in state taxation of series LLCs. Texas has provided some guidance with respect to the taxation of series LLCs for Texas franchise tax purposes after the comptroller’s issuance of Comptroller Private Letter Ruling 201005184L. In this ruling, the comptroller concluded that …

Power Play: An Examination Of Texas's Anti-Slapp Statute And Its Protection Of Free Speech Through Accelerated Dismissal., Dena M. Richardson

St. Mary's Law Journal

Abstract Forthcoming.

The Texas Anti-Indemnity Act., Taylor R. Beaver

St. Mary's Law Journal

Owners, general contractors, and subcontractors enter into agreements to ameliorate risk amongst those exercising control. Some of these include hold-harmless agreements, indemnity agreements, releases, and agreements conferring additional insured status to others. Typically, parties enjoy freedom to contract as they wish. Texas has long recognized, as a matter of public policy, a party’s right to draft contracts however it sees fit. Historically, risk-shifting agreements were enforceable if they passed the fair notice requirements, meaning the express negligence rule and the conspicuousness test. The trend in recent years, however, has been to limit exculpatory clauses. In 2011, the Texas Legislature effectively …