Insurance Law Commons^™

Sb 18 - Direct Primary Care, Valentin H. Dubuis, Juliana Mesa

Georgia State University Law Review

This legislation allows physicians to offer specified care for a specific time pursuant to a fixed fee. The physician cannot require more than one year’s payment upfront, and the agreement has to be terminable by either party with thirty days’ notice. Physicians do not have to provide care if the fee has not been paid or the patient has committed fraud, failed to adhere to treatment, or is in physical danger.

Sb 106 - Patients First Act, Jasmine Nicole Becerra, Leanne E. Livingston

Georgia State University Law Review

The Patients First Act amends both Title 49 and Title 33 of the Official Code of Georgia Annotated, which allows the state to apply for two federal waivers. One being the Section 1115 waiver to the Social Security Act. The second being the Section 1332 waiver to the Affordable Care Act. Section 1115 waivers apply to Medicaid and may be sought to include a maximum income threshold up to 100% of the Federal Poverty Level. The Section 1332 innovation waiver applies to insurance coverage generally.

Concussions And Contracts: The National Football League's Limitations To Protecting Its Players From Chronic Traumatic Encephalopathy, Julia Wolpert

Journal of Law and Health

Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative brain injury that has become prevalent among high-contact professional sports, especially American football. More and more retired players are exhibiting symptoms of CTE and being diagnosed with CTE post-mortem. While the neuroscience community constantly releases studies showing a causal connection between brain trauma and CTE, the National Football League (NFL) continues to deny that any brain injury can arise from playing football. The NFL must implement provisions in their contracts to fully inform and protect players from this lethal brain injury. This article examines the repercussions of CTE, how players’ contracts do and …

Insurance--Liability Of Insurer For Unauthorized Act Of Soliciting Agent, H. G. U.

West Virginia Law Review

No abstract provided.

Law School News: A Busy, Busy Time In Admiralty Law 10-18-2019, Michael M. Bowden

Life of the Law School (1993- )

No abstract provided.

Law School News: Inside Rwu Law's Small 'Admiralty Empire' 10-18-2019, Michael M. Bowden

Life of the Law School (1993- )

No abstract provided.

Bad Company? The Rise (Again) Of Association Health Plans, Brendan Williams

The Journal of Business, Entrepreneurship & the Law

This article first examines the rule adopted by the DOL and the criticism it has drawn. It then assesses the state of the small-group insurance market for small businesses, and the flawed approach that the ACA took to assisting them. Finally it takes a look at the uncertain future for small businesses and health insurance, and it suggests new approaches

10th Annual Pegalis Law Group Health Law Colloquium, New York Law School

Health Law Society Publications

Federalism, ERISA, and State Single-Payer Health Care. How to Make Sense of Future Legislation and the Impact on Population Health

(CLE Presentation on Oct. 24th 2019)

Moderator:

Adam S. Herbst, Esq., Senior Vice President, Chief Legal and Strategic Planning Officer of Blythedale’s Children Hospital; Adjunct Professor at New York Law School teaching Health Law and Policy; Co-director of the NYLS Health Law and Patient Safety Project; Lecturer, Mailman School of Public Health at Columbia University

Panelists:

Honorable Richard N. Gottfried, New York State Assembly (District 75) & Chairman of the Assembly's Committee on Health and Sponsor of …

Contracting For Healthcare: Price Terms In Hospital Admission Agreements, George A. Nation Iii

Dickinson Law Review (2017-Present)

This article discusses the application of contract law principles to the relationship between hospitals and patients to determine how much patients owe for the health care they receive. For patients who are covered by in-network health insurance the exact nature of the contract created with the hospital usually is not relevant to the patient’s financial obligation because the patient’s contract with the hospital is superseded by the contract between the patient’s health insurer and the hospital. Nevertheless, even in-network patients are financially impacted, via increased insurance premiums, by the contract analysis discussed here, and for the increasing number of patients …

Table Of Contents, Seattle University Law Review

Seattle University Law Review

No abstract provided.

Humanizing Work Requirements For Safety Net Programs, Mary Leto Pareja

Pace Law Review

This Article explores the political and policy appeal of work requirements for public benefit programs and concludes that inclusion of such requirements can be a reasonable design choice, but not in their current form. This Article’s proposals attempt to humanize these highly controversial work requirements while acknowledging the equity concerns they are designed to address. Drawing on expansive definitions of “work” found in guidance published by the Centers for Medicare and Medicaid (“CMS”) and in various state waiver applications, this Article proposes that work requirements be approved for Medicaid (as well as other benefit programs) only if they encompass various …

A Liability Insurer's Breach Of The Duty To Defend And The Often Erroneous Consequence Of Extracontractual Liability, Douglas R. Richmond

West Virginia Law Review

No abstract provided.

Humanizing Work Requirements For Safety Net Programs, Mary Leto Pareja

Faculty Scholarship

This Article explores the political and policy appeal of work requirements for public benefit programs and concludes that inclusion of such requirements can be a reasonable design choice, but not in their current form. This Article’s proposals attempt to humanize these highly controversial work requirements while acknowledging the equity concerns they are designed to address. Drawing on expansive definitions of “work” found in guidance published by the Centers for Medicare and Medicaid (“CMS”) and in various state waiver applications, this Article proposes that work requirements be approved for Medicaid (as well as other benefit programs) only if they encompass various …

Identifying The Legitimate Role Of The Value Of A Statistical Life In Legal Contexts, W. Kip Viscusi

Vanderbilt Law School Faculty Publications

This article is based on my keynote address at the American Academy of Economic and Financial Experts conference in which I examined some of the implications for legal contexts of my book, Pricing Lives: Guideposts for a Safer Society. The value of a statistical life (VSL) provides an economic measure of the efficient cost-risk tradeoff rate for mortality risk decisions. Consequently, the VSL is well suited to serving as a measure of the benefits of mortality risk reduction for government regulatory policies and for corporate risk decisions. The tort liability counterpart of this function is using the VSL to assess …

The Medicare Problem: A Solution To Insolvency, Oscar Castro

Brigham Young University Journal of Public Law

No abstract provided.

Loyalty And Betrayal, Bernhard Schlink

Cardozo Law Review

Role theory identifies people through the roles they choose and the way in which they coordinate them. That is no different from what we do when we meet someone and try to gain a sense of him or her. We ask about their profession, where they studied, enquire about their spouse and children, leisure activities, social and political engagement, and which clubs or church they attend. We try to discover the meaning that these various roles hold for the person and whether such roles are endowed with stronger or weaker emotional significance, are experienced as being more or less essential …

Department Of Insurance, Sarah Marie Burgh, Joseph Cheng, J. D. Fellmeth

California Regulatory Law Reporter

No abstract provided.

The Kids Are Not Alright: Leveraging Existing Health Law To Attack The Opioid Crisis Upstream, Yael Cannon

Georgetown Law Faculty Publications and Other Works

The opioid crisis is now a nationwide epidemic, ravaging both rural and urban communities. The public health and economic consequences are staggering; recent estimates suggest the epidemic has contracted the U.S. labor market by over one million jobs and cost the nation billions of dollars. To tackle the crisis, scholars and health policy initiatives have focused primarily on downstream solutions designed to help those who are already in the throes of addiction. For example, the major initiative announced by the U.S. Surgeon General promotes the dissemination of naloxone, which helps save lives during opioid overdoses.

This Article argues that the …

Drowsy Driving Considerations In Non-Commercial Drivers For The Sleep Physician, Ann Marie Marciarille, Anand Bhat, David Ingram, Damien Stevens

Faculty Works

The sleep physician faces many challenges in the assessment of drowsy driving. The following article reviews current clinical evaluation methods and legal considerations at the state level in the United States.

Moving Beyond Medical Debt, Brook E. Gotberg, Michael D. Sousa

Faculty Publications

In recent years it has become clear that medical costs are imposing severe financial burdens on American families, sometimes to the point that bankruptcy becomes the only escape from crippling debt. When evaluating the well-established connection between outstanding medical debt and consumer bankruptcy, most existing empirical studies attempt to quantify the percentage of consumer bankruptcies that are "caused" by unmanageable medical indebtedness. This Article addresses what we believe to be a more significant line of empirical inquiry, namely, the connection between health insurance coverage and consumer bankruptcy as a more precise measurement of how national health insurance programs may or …

Department Of Insurance, Sarah Marie Burgh, Joseph Cheng, Debra Jorgensen

California Regulatory Law Reporter

No abstract provided.

The Impact Of H.B. 214: A Critical Analysis Of The Texas "Rape Insurance" Bill, Lucie Arvallo

St. Mary's Law Journal

Texas House Bill 214 (H.B. 214) is subject to challenge under the Supreme Court precedent protecting a woman’s right to choose. Passed in 2017, H.B. 214 regulates Texas insurance markets by prohibiting coverage for an elective abortion unless a woman affirmatively opts into such coverage through a separate contract and pays a separate premium. Similar restrictions on insurance coverage for elective abortion in other states have been met with mixed results in the courts. What sets H.B. 214 apart from other regulations of insurance coverage for abortion is that it does not include any exceptions for abortions in cases of …

An Implied Defense: Self-Disclosure Offers A Defense To The Expanded False Claims Liability After Universal Health Services V. Escobar, Megan E. Italiano

William & Mary Law Review

No abstract provided.

Uncompensated Takings: Insurance, Efficiency, And Relational Justice, Brian Angelo Lee

Faculty Scholarship

No abstract provided.

Dual Regulation Of Insurance, Christopher C. French

Villanova Law Review (1956 - )

No abstract provided.

Mandatory Legal Malpractice Insurance: Exposing Lawyers' Blind Spots, Susan Saab Fortney

Faculty Scholarship

The legal landscape for lawyers’ professional liability in the United States is changing. In 2018, Idaho implemented a new rule requiring that lawyers carry legal malpractice insurance. The adoption of the Idaho rule was the first move in forty years by a state to require legal malpractice insurance since Oregon mandated lawyer participation in a malpractice insurance regime. Over the last two years, a few states have considered whether their jurisdictions should join Oregon and Idaho in requiring malpractice insurance for lawyers in private practice. To help inform the discussion, the article examines different positions taken in the debate on …

Table Of Contents, Seattle University Law Review

Seattle University Law Review

No abstract provided.

The Practice And Tax Consequences Of Nonqualified Deferred Compensation, David I. Walker

Washington and Lee Law Review

Although nonqualified deferred compensation plans lack explicit tax preferences afforded to qualified plans, it is well understood that nonqualified deferred compensation results in a joint tax advantage when employers earn a higher after-tax return on deferred sums than employees could achieve on their own. But the joint tax advantage depends critically on how plans are operated; chiefly how plan sponsors use or invest deferred compensation dollars. This is the first Article to systematically investigate nonqualified deferred compensation practices. It shows that joint tax minimization historically has taken a backseat to accounting priorities and participant diversification concerns. In recent years, the …

The Failed Promise Of Mental Health Parity In Virginia: A Missing Key In Mental Healthcare Access, Zachary Woerner

William & Mary Business Law Review

For those who suffer from the most serious mental illnesses, access to mental healthcare is critically important, but often frustrated by a Byzantine insurance system. The goal of this Note is to sift through the various mental health insurance parity laws, both nationally and statewide, and determine where this system breaks down. The Note will argue that lack of enforcement of parity laws plays a critical role in much of the dysfunction in the marketplace.

Legislation in Virginia and elsewhere is not always deficient on its face. Instead, laws critically lack regulators willing or able to implement them. This creates …

Insurance Appraisal In Texas And Its Place In Coverage Litigation, Brendan K. Mcbride, William J. Chriss, Matthew R. Pearson

St. Mary's Law Journal

Insurance appraisal is a contractually agreed process for resolving a disagreement between the insurance carrier and the policyholder about the amount of a loss under an insurance policy. Appraisal clauses have been a feature of insurance policies in Texas for well over a century. Old Texas cases were uniform to the effect that appraisal was a method to establish the “amount” of the loss under circumstances where coverage was not in dispute, but a recent line of cases has allowed insurers to escape liability for breach of contract, attorneys’ fees, statutory and common law “bad faith,” and even liability under …