Health Law and Policy Commons^™

The Grapes Of Wrath: On The Health Of Immigration Detainees, Stacey A. Tovino

Scholarly Works

This Article challenges the lack of health care provided to individuals in U.S. Immigration and Customs Enforcement (“ICE”) custody. As background, many immigration detainees are physically and emotionally vulnerable at the time of initial confinement due to a history of torture and trauma, which may include human trafficking, sexual violence, political oppression, psychosocial trauma, and acculturative stress. Detention can exacerbate preexisting vulnerabilities and contribute to severe physical and mental illness as well as death. Between October 2003 and October 2015, 153 individuals died while in ICE custody. Although most proposals for detainee health reform borrow heavily from constitutional law, international …

Crossing The Line: Daubert, Dual Roles, And The Admissibility Of Forensic Mental Health Testimony, Sara Gordon

Scholarly Works

Psychiatrists and other mental health professionals often testify as forensic experts in civil commitment and criminal competency proceedings. When an individual clinician assumes both a treatment and a forensic role in the context of a single case, however, that clinician forms a dual relationship with the patient—a practice that creates a conflict of interest and violates professional ethical guidelines. The court, the parties, and the patient are all affected by this conflict and the biased testimony that may result from dual relationships. When providing forensic testimony, the mental health professional’s primary duty is to the court, not to the patient, …

Regulating Healthcare Robots: Maximizing Opportunities While Minimizing Risks, Drew Simshaw, Nicolas Terry, Kris Hauser, M. L. Cummings

Scholarly Works

No abstract provided.

Reconciling The Premium Tax Credit: Painful Complications For Lower And Middle-Income Taxpayers, Francine J. Lipman, James E. Williamson

Scholarly Works

The Patient Protection and Affordable Care Act (ACA) makes available to certain middle and lower-income individuals a refundable tax credit, the Premium Tax Credit (PTC), designed to help them pay the premiums on their qualified health care plans. To achieve Congress’s goal of making health insurance affordable, the PTC is most often provided directly to an individual’s insurance provider each month in advance of actually claiming the PTC on the individual’s year-end annual tax return. Of the almost twelve million individuals who have enrolled in health insurance through the federal and state health exchanges in 2015, 85% of these individuals …

Gambling Disorder, Vulnerability, And The Law: Mapping The Field, Stacey A. Tovino

Scholarly Works

This Article seeks to descriptively map the sub-field of gambling disorder and the law and ask whether individuals with gambling disorder are vulnerable under the law. Like other scholarship that descriptively maps ethical, legal, and social implications of lesser known conditions and developments, this Article seeks to describe the treatment of individuals with gambling disorder in a variety of illustrative, but not exhaustive, legal contexts, to identify the limited scholarship assessing the application of the law to individuals with gambling disorder, and to invite members of the health law academy to bring their significant expertise to bear on these issues …

Complying With The Hipaa Privacy Rule: Problems And Perspectives, Stacey A. Tovino

Scholarly Works

Twenty years ago, President Clinton signed the Health Insurance Portability and Accountability Act of 1996 (HIPAA) into law. Over the past two decades, the federal Department of Health and Human Services (HHS) has published several sets of rules implementing the Administrative Simplification provisions within HIPAA as well as the Health Information Technology for Economic and Clinical (HITECH) Act within the American Recovery and Reinvestment Act (ARRA). These rules include a final rule governing the use and disclosure of protected health information by covered entities and their business associates (Privacy Rule).

This Article addresses the question of what it means for …

Dying Fast: Suicide In Individuals With Gambling Disorder, Stacey A. Tovino

Scholarly Works

These published remarks carefully document the history of health insurance coverage of gambling disorder. They begin by providing examples of gambling disorder insurance benefit disparities in the contexts of public health care programs and private health plans. They proceed by reviewing the effect of three pieces of legislation, including the Mental Health Parity Act of 1996, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, and the Affordable Care Act of 2010, on public and private insurance coverage of gambling disorder. They highlight the partial victory that will occur in some states beginning in …

The House Edge: On Gambling And Professional Discipline, Stacey A. Tovino

Scholarly Works

On March 26, 2014, the Iowa Supreme Court revoked the license to practice law of Cedar Rapids attorney Susan Hense. Admitted to the Iowa Bar in 1996, Hense subsequently misappropriated $837,000 in client trust funds to feed her addiction to casino gambling. This Article assesses how attorneys like Hense who are addicted to gambling are treated in professional disciplinary actions, including license suspension, revocation, and reinstatement proceedings. Themes that emerge include public misunderstanding of gambling disorder, stigma against individuals with gambling disorder, statutory recognition of substance addictions but not behavioral addictions, and mandatory attendance at religion based fellowship meetings as …

Subsidized Egg Freezing In Employment: Autonomy, Coercion, Or Discrimination?, Ann C. Mcginley

Scholarly Works

In 2014, Apple and Facebook announced that they would provide up to $20,000 for female employees to freeze their eggs as an employment benefit. These announcements raised mixed reviews. Some applauded the decision because they believe that egg freezing may offer to women more control over their reproductive choices. Others argued that the new benefit sends the wrong message to women and that encouraging good parenting by giving better parental leave and child care policies would be more beneficial to families. Others were concerned that this “benefit” applies only to professional or managerial-class women, but may not be helpful to …

Off-Label Drug Marketing, The First Amendment, And Federalism, David Orentlicher

Scholarly Works

In this article, Professor Orentlicher explores free speech and federalism issues arising from FDA regulation of off-label uses and off-label marketing of drugs. In light of the FDA's desire to respect state government authority, together with other considerations discussed in this article, he argues for the rejection of the analysis of the Caronia court and to give the FDA significant leeway in its regulation of off-label marketing.

Clinical Criteria For Physician Aid In Dying, David Orentlicher

Scholarly Works

More than 20 years ago, even before voters in Oregon had enacted the first aid in dying (AID) statute in the United States, Timothy Quill and colleagues proposed clinical criteria AID. Their proposal was carefully considered and temperate, but there were little data on the practice of AID at the time. (With AID, a physician writes a prescription for life-ending medication for a terminally ill, mentally capacitated adult.) With the passage of time, a substantial body of data on AID has developed from the states of Oregon and Washington. For more than 17 years, physicians in Oregon have been authorized …

Case No. 12 - Diagnosis Of A Stage Iii High Grade Right Breast Ductal Carcinoma In Right 1 Breast Of A 35 Year Old Woman Who Palpated A Lump Two Years Earlier., New York Law School

Anonymous Closed Medical Liability Cases

Anonymous Closed Medical Liability Case - Diagnosis of a Stage III High Grade Right Breast Ductal Carcinoma in Right 1 Breast of a 35 year old woman who Palpated a Lump two years earlier.

Case No. 5 - Paraplegia And Spinal Cord Signs Following A Breech Extraction, New York Law School

Anonymous Closed Medical Liability Cases

Anonymous Closed Medical Case - Paraplegia and Spinal Cord Signs Following a Breech Extraction

Case No. 7 - Postpartum Maternal Death Associated With Pulmonary Edema And Severe Anemia In A Patient With Preeclampsia, New York Law School

Anonymous Closed Medical Liability Cases

Anonymous Closed Medical Liability Case - Postpartum Maternal Death Associated with Pulmonary Edema and Severe Anemia in a Patient with Preeclampsia

Case No. 19 - Risks To The Sciatic Nerve Related To A Leg Lengthening Attempt In A Patient With Congenital Leg Shortening, New York Law School

Anonymous Closed Medical Liability Cases

Anonymous Closed Medical Liability Case - Risks to the Sciatic Nerve Related to a Leg Lengthening Attempt in a Patient with Congenital Leg Shortening

Case No. 14 - Pprom, New York Law School

Anonymous Closed Medical Liability Cases

Anonymous Closed Medical Liability Case - PPROM

Case No. 15 - Preterm Cervical Funneling And Incompetent Cervix Leading To A Preterm Birth, New York Law School

Anonymous Closed Medical Liability Cases

Anonymous Closed Medical Liability Case - Preterm Cervical Funneling and Incompetent Cervix Leading to a Preterm Birth

Case No. 22 - Paraplegia In A 12 Year Old With A Delayed Diagnosis And Treatment Of Transverse Myelitis, New York Law School

Anonymous Closed Medical Liability Cases

Anonymous Closed Medical Liability Case - Paraplegia in a 12 year old with a Delayed Diagnosis and Treatment of Transverse Myelitis

Case No. 24 - Postpartum Anemia And Pulmonary Edema Complicating A Hellp Syndrome Patient With Gallstone Surgery Resulting In A Maternal Death, New York Law School

Anonymous Closed Medical Liability Cases

Anonymous Closed Medical Liability Case - Postpartum Anemia and Pulmonary Edema Complicating a HELLP Syndrome Patient with Gallstone Surgery Resulting in a Maternal Death

Case No. 26 - Apls, New York Law School

Anonymous Closed Medical Liability Cases

Anonymous Closed Medical Liability Case - APLS

The Relationship Between Faculty Characteristics And The Use Of Norm- And Criteria-Based Grading, John Robst, Jennifer Vangilder, Caroline Elliott

Mental Health Law & Policy Faculty Publications

Norm-based grading has been associated with a reduction in student incentives to learn. Thus, it is important to understand faculty incentives for using norm-based grading. This paper used two waves of the National Study of Postsecondary Faculty to examine faculty characteristics related to the use of norm-based grading. Results suggest that norm-based grading is more likely when faculty and departments are more research oriented. Faculty who are at lower rank, male, younger, in science and social science departments are more likely to use norm-based grading, while faculty who feel that teaching should be the primary promotion criterion use criteria-based grading.

Prevalence And Predictors Of Substance-Related Emergency Psychiatry Admissions, M. Scott Young, Kathleen A. Moore

Mental Health Law & Policy Faculty Publications

Background: Individuals commonly present for emergency psychiatry services for reasons related to their use of alcohol or illicit drugs. This study assessed the prevalence of these phenomena and explored characteristics distinguishing emergency psychiatry admissions with versus without presenting problems related to substance use. Methods: Data included standardized emergency psychiatry intake interviews from 2,161 consecutive admissions to three hospital-based emergency psychiatry departments in Florida’s Tampa Bay area. Admissions were classified as substanceinvolved if substance use was ascertained to be related to the presenting problem(s). Cases with only substance-related presenting problems were classified as substance-only admissions. Descriptive statistics compared substance-involved admissions to …

Table Of Contents

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Masthead

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Key Issues Facing Medicaid After The Affordable Care Act, Marybeth Musumeci

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Medicaid, Managed Care, And The Mission For The Poor, John V. Jacobi

Saint Louis University Journal of Health Law & Policy

Medicaid has financed care for the poor for five decades. During that time it has balanced two important missions: providing for the particular health needs of the poor, and mainstreaming care for the poor. These roles have been consistent as all insurance payors—public and private—have shifted away from passively funding fragmented care to actively supporting patient-centered coordinated care. But the health needs of the poor go beyond medical interventions; the health status of the poor depends on the provision of social services to address social determinants of health, including housing, nutrition, and employment training services. Unlike non-poor insureds, Medicaid beneficiaries …

Pin The Tail On The Donkey: Beneficiary Enforcement Of The Medicaid Act Over Time, Jane Perkins

Saint Louis University Journal of Health Law & Policy

During the twentieth century, Congress enacted legislation designed to improve the lives of low-income Americans. A number of these laws were enacted by Congress pursuant to the Constitution’s Spending Clause, including the Medicaid Act, which entitles certain low-income individuals to publicly funded health insurance coverage. As enacted in 1965, the Medicaid Act did not include a provision authorizing the statute’s beneficiaries to bring private enforcement actions in court. Since the early 1970s, however, program beneficiaries relied upon the Constitution’s Supremacy Clause or, more frequently, 42 U.S.C. § 1983 for the cause of action allowing them to obtain relief in court. …

On The Expansion Of “Welfare” And “Health” Under Medicaid, Laura D. Hermer

Saint Louis University Journal of Health Law & Policy

Medicaid was intended from its inception to provide financial access to health care for certain categories of impoverished Americans. While rooted in historical welfare programs, it was meant to afford the “deserving” poor access to the same sort of health care that other, wealthier Americans received. Yet despite this seemingly innocuous and laudable purpose, it has become a front in the political and social battles waged over the last several decades on the issues of welfare and the safety net. The latest battleground pits competing visions of Medicaid. One vision seeks to transform Medicaid from a health care program into …

Premiums And Section 1115 Waivers: What Cost Medicaid Expansion?, Sidney D. Watson

Saint Louis University Journal of Health Law & Policy

States reluctant to adopt the Affordable Care Act’s Medicaid expansion are demanding that the U.S. Department of Health and Human Services grant them Section 1115 demonstration waivers that allow them to charge poor people premiums.

The U.S. Department of Health and Human Services has yielded to these demands, granting five states waivers of long standing federal statutory protections that limit state discretion to impose premiums for Medicaid. These premium waivers present a fundamental problem of law because the Secretary of the U.S. Department of Health and Human Services has no statutory authority to grant Section 1115 waivers that allow states …

Mergers And Monopolies: An Examination Of The Cyclical Effect Of Anti-Competition And A Lack Of Rate Regulation In Health Care, Madeline J. Bainer

Saint Louis University Journal of Health Law & Policy

Health care costs continue to rise, forcing consumers to make difficult choices between seeking expensive treatment and risking the consequences without. To combat the inflation of health care costs, the Affordable Care Act implemented a number of policies aimed at improving the quality of care while lowering the cost of that care. In order to accomplish the goals of the Affordable Care Act, health care systems began merging with one another and acquiring smaller groups to incorporate into a vast network of providers. However, many of these mergers offer little value to consumers. Instead, they ultimately drive up the cost …