Health Law and Policy Commons^™

Medical Malpractice And Black-Box Medicine, W. Nicholson Price Ii

Book Chapters

The explosive proliferation of health data has combined with the rapid development of machine-learning algorithms to enable a new form of medicine: “black-box medicine.” In this phenomenon, algorithms troll through tremendous databases of health data to find patterns that can be used to guide care, whether by predicting unknown patient risks, selecting the right drug, suggesting a new use of an old drug, or triaging patients to preserve health resources. These decisions differ from previous data-based decisions because black-box medicine is, by its nature, opaque; that is, the bases for black-box decisions are unknown and unknowable.

Black-box medicine raises a …

Interpreting Canada's Medical Assistance In Dying Legislation, Jocelyn Downie, Jennifer A. Chandler

Reports & Public Policy Documents

When the Canadian medical assistance in dying (MAiD) legislation came into force in June 2016, it was widely noted that the meaning of some of its key terms and phrases was unclear. For example, questions were immediately raised about the meaning of “incurable illness, disease, or disability,” “advanced state of irreversible decline in capability,” and “natural death has become reasonably foreseeable.” Interpretation challenges are not uncommon with new legislation. However, in the context of something as significant as access to MAiD and potential criminal liability for getting the meaning of the legislation wrong, these challenges must be confronted by those …

Masthead, Volume 28 (2018)

Health Matrix: The Journal of Law-Medicine

No abstract provided.

Health Care Held Ransom: Modifications To Data Breach Security & The Future Of Health Care Privacy Protection, Ryan M. Krisby

Health Matrix: The Journal of Law-Medicine

The article highlights the need of modification in the U.S. Health Insurance Portability and Accountability Act of 1996 (HIPAA), as the federal data breach security regulation fails to adequately protect patient data. Topics discussed include data breach security under HIPAA; need of modifications that address these inadequacies concerning ransomware; and actions by the U.S. Federal Trade Commission to provide an impetus for healthcare organizations to carry out data security modifications.

Needles, Haystacks, And Next-Generation Genetic Sequencing, Teneille R. Brown

Health Matrix: The Journal of Law-Medicine

Genetic testing is becoming more frequent and the results more complex. Not infrequently, genetic testing conducted for one purpose reveals information about other features of the genome that may be of clinical significance. These unintended findings have been referred to as "incidental" or "secondary" findings. In 2013, the American College of Medical Genetics ("ACMG") recommended that clinical laboratories inform people if their genetic analyses indicate that they have certain secondary mutations. These mutations were selected because they probably cause a serious disease, which is treatable, and may go undetected. The ACMG's recommendations galvanized critical responses by the genetics and ethics …

The Moderating Relationship Of Comorbid Psychopathology And Treatment Outcome For Young Adult Offenders In Drug Court, Patrick Mcgonigal, Kathleen A. Moore, Matthew Scott Young

Mental Health Law & Policy Faculty Publications

Title: The moderating relationship of comorbid psychopathology and treatment outcome for young adult offenders in drug court.

Background: The drug court system is an alternative to incarceration that provides offenders with non-violent, substance motivated crimes with an opportunity to dismiss their charges and undergo a rigorous substance abuse treatment program. It is unknown whether drug court is effective for young adult clients and the role of co-occurring psychopathology within this context.

Methods: This study evaluated the overall effectiveness of a drug court system applied to young adult offenders ages 18-26, and additionally explored the moderating relationship of psychiatric symptoms on …

Wecan! A 12-Month Evaluation Of A Drug Court Treatment Program Serving Females Addicted To Prescription Drugs, Kathleen A. Moore, M. Scott Young

Mental Health Law & Policy Faculty Publications

Prescription drug abuse represents a national public health concern. This study reports on 12-month outcomes of a drug court treatment program for 102 female offenders addicted to prescription drugs. The program utilized two evidence-based treatment models (i.e., Motivational Enhancement Therapy/Cognitive Behavioral Therapy-12 and Seeking Safety). In addition, participants were required to attend monthly judicial reviews, weekly AA/NA groups, and two random drug screens per week. Participants were interviewed at baseline and 12-month follow-up. Analyses examined self-reported substance use, traumatic experiences, criminal justice involvement, readiness to change, and therapeutic alliance. Participants reported significant decreases in substance use, increased readiness to change, …

The Duration Of Untreated Psychosis: A Phenomenological Study, Sarah R. Kamens, Larry Davidson, Emily Hyun, Nev Jones, Jill G. Morawski, Matthew M. Kurtz, Jessica Pollard, Gerrit Ian Van Schalkwyk, Vinrod Srihari

Mental Health Law & Policy Faculty Publications

Mounting evidence has indicated that early intervention leads to improved clinical and functional outcomes for young persons experiencing recent onset psychosis. As part of a large early detection campaign, the present study aimed to investigate subjective experiences during the duration of untreated psychosis (DUP), or time between psychosis onset and treatment contact. Participants were 10 young adults participating in early intervention services for psychosis. After DUP was estimated during standardized baseline assessment, participants engaged in qualitative interviews focused on their life experiences prior to treatment and leading up to the present. Mixed methods data analyses compared standardized DUP estimates with …

Law, Religion, And Health Care, David Orentlicher

Scholarly Works

No abstract provided.

Health Care Reform: What Has Been Accomplished What Comes Next, David Orentlicher

Scholarly Works

No abstract provided.

A Right To Care, Stacey A. Tovino

Scholarly Works

In this Article, Professor Stacey Tovino examines the right to care through a personal and historical lens, then attempts to fill a scholarly gap in legal literature surrounding the right to skilled care and rehabilitation for patients with group or commercial insurance. Professor Tovino first recounts the history of Medicare coverage for skilled care and rehabilitation, then she examines the limitations of group and commercial insurance, finally concluding by asserting a right to care.

Emtala's Impact On Patients' Rights In Colorado Emergency Rooms, Jack Vihstadt

University of Colorado Law Review

During the Reagan Administration, Congress enacted the Emergency Medical Treatment and Labor Act (EMTALA) to crack down on hospital emergency departments (EDs) that were refusing to treat poor patients. The Act prohibited EDs from screening patients based on their ability to pay. Thirty years later, EDs have used provisions of the Act to dodge questions from curious patients about their treatment options and costs. In 2016, two Democrats introduced a bill into the Colorado General Assembly that would provide a warning to emergency department patients without an emergency condition that an urgent care center or a primary care physician may …

Medical Necessity: A Higher Hurdle For Marginalized Taxpayers?, Julie Furr Youngman, Courtney D. Hauck

Loyola of Los Angeles Law Review

Civil rights protection for transgender people—and in particular access to affordable health care—is currently the subject of intense political scrutiny, with a hostile administration chipping away at legal protections. Among other setbacks, a federal district court enjoined regulatory guidelines that were issued in 2016 to clarify that the federal prohibition on sex discrimination in health insurance applies to discrimination on the basis of gender identity and transgender status, and the promulgating agency itself is now reconsidering the guidelines. Without explicit federal protections against discrimination by health insurers and in the face of uneven state law protections, the ability to deduct …

Table Of Contents

Marquette Benefits and Social Welfare Law Review

No abstract provided.

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.

Regulatory Implications Of The Comprehensive Care For Joint Replacement Demonstration Project, Thomas W. Brewer

Saint Louis University Journal of Health Law & Policy

An often overlooked provision in the Patient Protection and Affordable Care Act is the authorization of demonstration projects which incentivize providers to develop, implement, and test novel, cost-cutting approaches to care delivery. One such project, the Comprehensive Care for Joint Replacement demonstration project, encourages providers across the continuum of care to collaborate on strategies that improve the quality of and lower the cost of complete joint replacements. The project allows providers to share the benefits of cost savings, and liabilities for cost overruns, across the surgeons performing procedures, acute care facilities, and post-acute care facilities. Arrangements of this type, outside …

Putting The Brakes On Consumer Driven Medicaid: The Failures And Harms Of Healthy Indiana Plan (Hip) 2.0, Sidney D. Watson

Saint Louis University Journal of Health Law & Policy

In January 2015, the U.S. Department of Health and Human Services (HHS) granted Indiana a Section 1115 Demonstration Waiver to experiment with consumer driven Medicaid. The Healthy Indiana Plan (HIP) 2.0 combines a $2,500 high deductible with a Personal Responsibility and Wellness (POWER) Account, premiums, and copays. Described as “the most significant departure from traditional Medicaid ever approved,” Indiana claims that the POWER Account, the signature feature of HIP 2.0, is “similar to a health savings account (HSA)” and encourages members to be more cost-conscious consumers, helps familiarize members with how commercial health insurance works, and encourages continuous Medicaid enrollment. …

The Body Politic: Federalism As Feminism In Health Reform, Elizabeth Y. Mccuskey

Saint Louis University Journal of Health Law & Policy

This essay illuminates how modern health law has been mainstreaming feminism under the auspices of health equity and social determinants research. Feminism shares with public health and health policy both the empirical impulse to identify inequality and the normative value of pursing equity in treatment. Using the Affordable Care Act’s federal health insurance reforms as a case study of health equity in action, the essay exposes the feminist undercurrents of health insurance reform and the impulse toward mutuality in a body politic. The essay concludes by revisiting—from a feminist perspective—scholars’ arguments that equity in health insurance is essential for human …

Finding An Unlikely Combatant In The War Against Ransomware: Opportunities For Providers To Utilize Off-Site Data Backup Within The Hipaa Omnibus And Hitech Amendments, Jordan Butler

Saint Louis University Journal of Health Law & Policy

Each day the health care sector is subjected to an onslaught of thousands of ransomware virus attacks which attempt to capture a provider’s IT operations until a ransom is paid to the hacker. Apart from monetary, functional, and civil liability considerations, compromised health systems that contain electronic patient health information could expose a provider to legal liability under multiple HIPAA laws. This article will explore how recent amendments made to HIPAA, particularly under the Omnibus and HITECH Acts, incentivize providers to obtain legal, functional, and policy-based benefits by utilizing off-site data backup business associates as part of their cybersecurity defense …

Overlapping And Concurrent Surgeries: An Analysis Of Informed Consent When There Is Incomplete Risk Information, Caitlan E. Grombka-Murphy

Saint Louis University Journal of Health Law & Policy

The practice of overlapping and concurrent surgeries—where a single surgeon runs two or more operations at once—is not new. However, it was not until 2015, through the Boston Globe’s investigation, that the general public learned the details of such practices. Lack of transparency surrounding these practices regrettably has created a culture of distrust within the surgeon-patient relationship. The core concern of overlapping and concurrent surgeries is the potential for patient risk. Scientific research on how much additional risk overlapping or concurrent surgeries place on the patient is still in its early stages. This article explores current scientific research, noting …

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.

Foreword, Robert Gatter

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Independence Is The New Health, Laura D. Hermer

Saint Louis University Journal of Health Law & Policy

Medicaid plays key roles in supporting our nation’s health. Under the Affordable Care Act, Medicaid took an even more central position in public health endeavors by extending coverage in all interested states to millions of adults who typically fell through the health care cracks. Nevertheless, the Trump administration is now undoing these gains by actively encouraging states to curtail access to Medicaid in key respects while using the rhetoric of health.

This article examines Trump administration efforts in two contexts: (1) state § 1115 waiver applications seeking to better align their Medicaid programs with cash welfare and food stamp programs, …

Health Justice In The Age Of Alternative Facts And Tax Cuts: Value-Based Care, Medicaid Reform, And The Social Determinants Of Health, Elizabeth Tobin-Tyler

Saint Louis University Journal of Health Law & Policy

Some provisions of the Patient Protection and Affordable Care Act of 2010 (ACA) as well as regulatory policies under the Obama administration reflected the overwhelming evidence that to reduce health care costs, and to improve quality of care and population health, the social determinants of health (SDOH) must be addressed. These policies included funding for partnerships between public health agencies, community organizations, and health care institutions, promotion of value-based payment models that incentivize integrated health and social care delivery, and support for Medicaid program innovations that directly address social needs as part of health care. The Trump administration, through a …

What Hope For Health In All Policies’ Addition And Multiplication Of Equity In An Age Of Subtraction And Division At The Federal Level?: The Memphis Experience, Amy T. Campbell

Saint Louis University Journal of Health Law & Policy

Increasingly, people recognize that social factors, such as poverty, the living environment, and educational status, substantially affect health outcomes. A “health in all policies approach” (HiAP) seeks structural reform of policymaking to require purposeful consideration, across an interconnected range of public sector actors, of the health equity and justice policy-level considerations of these factors. With the election of Donald J. Trump as 45th President in the United States, however, the U.S. entered a world where the math of the day is division and subtraction, rather than addition or multiplication. And yet, hope in HiAP remains through examples of innovative approaches …

Political Rhetoric And Minority Health: Introducing The Rhetoric-Policy-Health Paradigm, Kimberly Cogdell Grainger

Saint Louis University Journal of Health Law & Policy

Rhetoric is a persuasive device that has been studied for centuries by philosophers, thinkers, and teachers. In the political sphere of the Trump era, the bombastic, social media driven dissemination of rhetoric creates the perfect space to increase its effect. Today, there are clear examples of how rhetoric influences policy. This Article explores the link between divisive political rhetoric and policies that negatively affect minority health in the U.S. The rhetoric-policy-health (RPH) paradigm illustrates the connection between rhetoric and health. Existing public health policy research related to Health in All Policies and the social determinants of health combined with rhetorical …

The Faltering Promise Of Fda Tobacco Regulation, Micah L. Berman

Saint Louis University Journal of Health Law & Policy

Congress passed the Tobacco Control Act (TCA) in 2009, giving the FDA the authority to regulate tobacco products for the first time. Ten years later, the promise that the TCA’s enactment would be a transformative moment for public health has not materialized. To the contrary, the FDA’s most notable regulatory effort—requiring graphic warnings on cigarette packages and advertisements—has been struck down in court, and the FDA is now scrambling to address a youth e-cigarette epidemic that caught it off guard. This Article provides a brief review of TCA implementation during the Obama administration, and it reviews the Trump administration’s “comprehensive …

“I Walk In, Sign. I Don’T Have To Go Through Congress.” President Trump’S Use Of Executive Orders To Unravel The Patient Protection And Affordable Care Act, Elizabeth Van Nostrand, Tina Batra Hershey

Saint Louis University Journal of Health Law & Policy

Executive orders, used by presidents to advance their administrations’ agendas, have changed history. These powerful written instruments were used to confine Japanese Americans during World War II, desegregate public schools, and create NASA. On the day of his inauguration, President Donald J. Trump issued his first Executive Order which directed secretaries of executive branch agencies to begin dismantling President Barack Obama’s flagship initiative—the Patient Protection and Affordable Care Act (ACA). This action, along with subsequent executive orders, precipitated a flurry of regulatory change and judicial challenges. Whether President Trump will ultimately be successful in crippling the ACA is still to …