Health Law and Policy Commons^™

Cooperative Federalism And Healthcare Reform: The Medicare Part D 'Clawback' Example, Elizabeth Weeks Leonard

Scholarly Works

This symposium article recounts recent litigation by several states over a provision of the Medicare Modernization Act Part D prescription drug benefit: The clawback, which requires states to pay the a potentially substantial portion of new federal program. I then examine the unique federalism implications of the clawback for ongoing state and federal health reform initiatives.

In spring 2006, several states petitioned the United States Supreme Court for original jurisdiction to hear a challenge to one provision of the new Medicare Part D prescription drug law. The federal government, while taking over prescription drug coverage for dually eligible beneficiaries, required …

How I Learned To Stop Worrying And Love The Gats: An Examination Of The Impact Of The General Agreement On Trade In Services On The Canadian Health-Care System, Brian N. Zeiler-Kligman

Dalhousie Law Journal

There is perhaps no more cherished Canadian institution than our universal health-care system, Medicare. Despite Canadians' fondness for Medicare, there are often allegations that various external elements threaten Medicare's viability. One of these oft-cited elements is the General Agreement on Trade in Services (GATS), which some have claimed will force the privatization of all public services. The truth in such claims is tested by examining the effect the GATS is likely to have on the Canadian health-care system. The examination includes an interpretation of GATS Article 1.3 through a textual analysis. GATS' impact on this system is explored on three …

The Three Faces Of Retainer Care, Frank A. Pasquale

ExpressO

Retainer care arrangements allow patients to pay a fee directly to a physician’s office in order to obtain special access to care. Practices usually convert to retainer status by concentrating their attention on a small panel and dropping the majority of their patients. Proponents call retainer care a triumph of consumer-directed health care; opponents deride it as “boutique medicine.” Both sides are deploying a variety of legal tactics in order to attain their goals.

After surveying these conflicts, this article clarifies what is at stake by analyzing the three key features of retainer care: preventive care, queue-jumping, and amenity-bundling. Most …

The Role Of Medicare In Medical Malpractice Reform, William M. Sage

Journal of Health Care Law and Policy

No abstract provided.

Reform Of Medical Liability And Patient Safety: Are Health Courts And Medicare The Keys To Effective Change?, Randall R. Bovbjerg

Journal of Health Care Law and Policy

No abstract provided.

Health Courts And Malpractice Claims Adjudication Through Medicare: Some Questions, Timothy Stoltzfus Jost

Journal of Health Care Law and Policy

No abstract provided.

An Advocate's Response To Professor Sage, Toby S. Edelman

Journal of Health Care Law and Policy

No abstract provided.

Blame Canada (And The Rest Of The World): The Twenty-Year War On Imported Prescription Drugs, Daniel L. Pollock

ExpressO

Rising budget deficits and sticker shock over the new Medicare drug benefit have put the issue of prescription drug costs back into the spotlight. The growth in the cost of prescription drugs continues to represent a staggering burden for taxpayer-funded health care programs, even while costs of non-drug health care services have slowed or even decreased. Among the many proposals for cutting prescription drug costs, drug importation is unique. Although bipartisan support for drug importation has existed in Congress for over five years, the federal government continues to maintain that a system of safe and effective drug importation is impossible. …

A Right To No Meaningful Review: The Aftermath Of Shalala V. Illinois Council On Long Term Care, Inc., Ruqaiijah Ayanna Yearby

ExpressO

A RIGHT TO NO MEANINGFUL REVIEW: THE AFTERMATH OF SHALALA v. ILLINOIS COUNCIL ON LONG TERM CARE, INC. Ruqaiijah A. Yearby

The Due Process Clause of the Fifth Amendment has been perverted in the federal administrative system. Federal agencies, such as the U.S. Department of Health and Human Services (HHS), regularly deprive individuals of liberty and property with little to no review. In its regulation of the health care industry through the Medicare program, HHS often turns a blind eye to procedural Due Process protections, such as providing individuals an opportunity to challenge the deprivation of property at a hearing, …

The Boundaries Of Medicare: Tensions In The Dual Role Of Ontario's Physician Services Review Committee, Colleen M. M. Flood, Joanna Erdman

Articles, Book Chapters, & Popular Press

In this research, we describe and analyse the Physician Services Committee (PSC) in Ontario, focusing on its role in determining what physician services are publicly funded and what services are de-listed (i.e. no longer eligible for public funding). We explain how the PSC's role in determining the boundaries of Medicare is in tension with its role as a medium for labour relations between the government and the medical profession. We suggest that while the values of privacy, secrecy and a lack of transparency may enhance the PSC's fulfillment of its labour relations mandate, they impede the Committee's successful fulfillment of …

Gauging The Cost Of Loopholes: Health Care Pricing And Medicare Regulation In The Post-Enron Era, Elizabeth Weeks Leonard

Scholarly Works

This article explores the problem of risk perception and regulatory loopholes in the unique era of corporate governance that followed Enron and other high-profile corporate scandals. The article draws on behavioral law and economics theory to examine pressing issues in U.S. welfare policy reform. The current Administration's domestic agenda features proposals to privatize traditional government welfare programs, including Social Security and Medicare. Those proposals rely on market competition and other profit incentives to improve quality and reduce program costs. The article traces a detailed case study of a prominent for-profit hospital corporation, the impact of public perceptions of corporate wrongdoing, …

Why Don't Doctors & Lawyers (Strangers In The Night) Get Their Act Together?, Frances H. Miller

Michigan Law Review

Health care in America is an expensive, complicated, inefficient, tangled mess - everybody says so. Patients decry its complexity, health care executives bemoan its lack of coherence, physicians plead for universal coverage to simplify their lives so they can just get on with taking care of patients, and everyone complains about health care costs. The best health care in the world is theoretically available here, but we deliver and pay for it in some of the world's worst ways. Occam's razor ("Among competing hypotheses, favor the simplest one") is of little help here. There are no simple hypotheses - everything …

Universal Coverage And The American Health Care System In Crisis (Again), Rick Mayes

Journal of Health Care Law and Policy

No abstract provided.

Medicare At 40: A Mid-Life Crisis?, Nancy-Ann Deparle

Journal of Health Care Law and Policy

No abstract provided.

Be Not Afraid Of Change: Time To Eliminate The Corporate Practice Of Medicine Doctrine, Nicole Huberfeld

Law Faculty Scholarly Articles

This article focuses on three key reasons that the corporate practice of medicine doctrine should be laid to rest. First, the motives for creating the corporate practice of medicine doctrine are long gone; it has been some time since physicians have been able to operate as a guild of autonomous providers of health care. The delivery and financing of health care places physicians in an integrated system that is only frustrated by the corporate practice of medicine doctrine. Second, it is disingenuous to pretend that physicians are not influenced by financial gain. This is handily evidenced by the federal and …

Medicare Meets Mephistopheles, David A. Hyman

Washington and Lee Law Review

No abstract provided.

The Politics Of Medicare Reform, Jonathan Oberlander

Washington and Lee Law Review

No abstract provided.

Medicare And Political Analysis: Omissions, Understandings, And Misunderstandings, Theodore Marmor, Spencer Martin, Jonathan Oberlander

Washington and Lee Law Review

No abstract provided.

Modernizing Medicare's Benefit Structure, Marilyn Moon

Washington and Lee Law Review

No abstract provided.

What If Technology Never Stops Improving? Medicare's Future Under Continuous Cost Increases, Mark V. Pauly

Washington and Lee Law Review

No abstract provided.

Paying For Quality And Doing It Right, Robert A. Berenson

Washington and Lee Law Review

No abstract provided.

Beyond Beneficiaries: Using The Medicare Program To Accomplish Broader Public Goals, Dean M. Harris

Washington and Lee Law Review

No abstract provided.

Mediating With An 800-Pound Gorilla: Medicare And Adr, Phyllis E. Bernard

Washington and Lee Law Review

No abstract provided.

Medicare Coverage Decision-Making And Appeal Procedures: Can Process Meet The Challenge Of New Medical Technology?, Eleanor D. Kinney

Washington and Lee Law Review

No abstract provided.

The Future Of Medicare, Post Great Society And Post Plus-Choice: Legal And Policy Issues--Foreword, Timothy Stoltzfus Jost

Washington and Lee Law Review

No abstract provided.

If Paying For Quality Is Such A Bad Idea, Why Is Everyone For It?, Bruce C. Vladeck

Washington and Lee Law Review

No abstract provided.

The Administration Of Medicare: A Neglected Issue, Thomas H. Stanton

Washington and Lee Law Review

No abstract provided.

Why We Need The Independent Sector: The Behavior, Law, And Ethics Of Not-For-Profit Hospitals, Jill R. Horwitz

Articles

Among the major forms of corporate ownership, the not-for-profit ownership form is distinct in its behavior, legal constraints, and moral obligations. A new empirical analysis of the American hospital industry, using eleven years of data for all urban general hospitals in the country, shows that corporate form accounts for large differences in the provision of specific medical services. Not-for-profit hospitals systematically provide both private and public goods that are in the public interest, and that other forms fail to provide. Two hypotheses are proposed to account for the findings, one legal and one moral. While no causal claims are made, …

Health Care Law, Peter M. Mellette, Emily W. G. Towey, J. Vaden Hunt

University of Richmond Law Review

No abstract provided.

The Medicare Anti-Kickback Statute: In Need Of Reconstructive Surgery For The Digital Age, Michael E. Paulhus

Washington and Lee Law Review

No abstract provided.