Health Law and Policy Commons^™

Communicable Diseases And The Right To Re-Enter The United States, J. Nicholas Murosko

William & Mary Bill of Rights Journal

No abstract provided.

Selected Issues Concerning The Ethical Use Of Big Data Health Analytics, Lieke Jetten, Stephen Sharon

Washington and Lee Law Review Online

No abstract provided.

The Effect Of Pegram V. Herdrich On Hmo Liability, Dawn Marie Kelly

Touro Law Review

No abstract provided.

The Contraception Mandate Accomodated: Why The Rfra Claim In Zubik V. Burwell Fails, Caroline Mala Corbin

Short Works

No abstract provided.

Physician Quality Reporting System Program Updates And The Impact On Emergency Medicine Practice., Jennifer L Wiler, Michael Granovsky, Stephen V Cantrill, Richard Newell, Arjun K Venkatesh, Jeremiah D Schuur

Emergency Medicine Faculty Publications

In 2007, the Centers for Medicaid and Medicare Services (CMS) created a novel payment program to create incentives for physician's to focus on quality of care measures and report quality performance for the first time. Initially termed "The Physician Voluntary Reporting Program," various Congressional actions, including the Tax Relief and Health Care Act of 2006 (TRHCA) and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) further strengthened and ensconced this program, eventually leading to the quality program termed today as the Physician Quality Reporting System (PQRS). As a result of passage of the Affordable Care Act of 2010, …

Hospital Mergers And Economic Efficiency, Roger D. Blair, Christine Piette Durrance, D. Daniel Sokol

Washington Law Review

Consolidation via merger both from hospital-to-hospital mergers and from hospital acquisitions of physician groups is changing the competitive landscape of the provision of health care delivery in the United States. This Article undertakes a legal and economic examination of a recent Ninth Circuit case examining the hospital acquisition of a physician group. This Article explores the Saint Alphonsus Medical Center-Nampa Inc. v. St. Luke’s Health System, Ltd. (St. Luke’s) decision—proposing a type of analysis that the district court and Ninth Circuit should have undertaken and that we hope future courts undertake when analyzing mergers in the health care …

Buyers In The Baby Market: Toward A Transparent Consumerism, June Carbone, Jody Lyneé Madeira

Washington Law Review

This Article assesses the forces on the horizon remaking the fertility industry, including greater consolidation in the health care industry, the prospects for expanding (or contracting) insurance coverage, the likely sources of funding for future innovation in the industry, and the impact of globalization and fertility tourism. It concludes that concentration in the American market, in contrast with other medical services, may not necessarily raise prices, and price differentiation may proceed more from fertility tourism than from competition within a single geographic region. The largest challenge may be linking those who would fund innovation, whether innovation that produces new high …

The Law, Economics, And Medicine Of Off-Label Prescribing, William S. Comanor, Jack Needleman

Washington Law Review

There is a major dissonance in the current structure of regulating new drugs that have more than one medical indication. Physicians are authorized to prescribe these drugs for all indications including those beyond their approved purposes. However, product manufacturers are expressly prohibited from marketing or promoting their drugs for any purpose other than those which have been specifically indicated. While prescribing physicians are encouraged to gain medical information on any additional indications, they cannot obtain it from one of its most likely sources: the drug’s supplier. The Second Circuit Court of Appeals’ recent opinion in United States v. Caronia has …

A Flexible Health Care Workforce Requires A Flexible Regulatory Environment: Promoting Health Care Competition Through Regulatory Reform, Andrew I. Gavil, Tara Isa Koslov

Washington Law Review

Effective competition policy is critical to the success of U.S. health care reform, including efforts to reduce health care costs, increase quality of care, and expand access to health care services. While promoting competition is necessary at every level of the rapidly evolving health care system, it is particularly important with respect to licensed professionals who provide health care services. This Article argues that the current system of health care professional regulation, born of the last century, is in numerous respects an impediment to the kinds of changes needed to fully unleash the benefits of competition among different types of …

Navigating Through The Fog Of Vertical Merger Law: A Guide To Counselling Hospital-Physician Consolidation Under The Clayton Act, Thomas L. Greaney, Douglas Ross

Washington Law Review

Lawyers assessing legality under the antitrust laws of hospital acquisitions of physician practices face a quandary. The case law is sparse, federal enforcement guidance outdated, and academic input conflicting. Applying these muddled standards in the rapidlyevolving health care sector only magnifies the uncertainty. While most transactions will be competitively neutral or beneficial, rapidly evolving market conditions causing integration between hospitals and physicians present opportunities for consolidations that may harm consumer interests. Indeed, given the highly concentrated structure of many hospital markets in the nation, preemptive acquisitions of physician practices may be a tempting strategy for some to undermine competition. This …

Buyer Power And Healthcare Prices, John B. Kirkwood

Washington Law Review

One major reason why healthcare spending is much higher in America than in other countries is that our prices are exceptionally high. This Article addresses whether we ought to rely more heavily on buyer power to reduce those prices, as other nations do. It focuses on two sectors where greater buyer power could easily be exercised: prescription drugs covered by Medicare and hospital and physician services covered by private insurance. The Article concludes that the biggest buyer of all, the federal government, should be allowed to negotiate Medicare prescription drug prices. This would likely reduce the prices of many branded …

Hospital Mergers And Economic Efficiency, Roger D. Blair, Christine Piette Durrance, D. Daniel Sokol

UF Law Faculty Publications

Consolidation via merger both from hospital-to-hospital mergers and from hospital acquisitions of physician groups is changing the competitive landscape of the provision of health care delivery in the United States. This Article undertakes a legal and economic examination of a recent Ninth Circuit case examining the hospital acquisition of a physician group. This Article explores the Saint Alphonsus Medical Center-Nampa Inc. v. St. Luke’s Health System, Ltd. (St. Luke’s) decision—proposing a type of analysis that the district court and Ninth Circuit should have undertaken and that we hope future courts undertake when analyzing mergers in the …

Buyers In The Baby Market: Toward A Transparent Consumerism, June Carbone, Jody Lyneé Madeira

Washington Law Review

This Article assesses the forces on the horizon remaking the fertility industry, including greater consolidation in the health care industry, the prospects for expanding (or contracting) insurance coverage, the likely sources of funding for future innovation in the industry, and the impact of globalization and fertility tourism. It concludes that concentration in the American market, in contrast with other medical services, may not necessarily raise prices, and price differentiation may proceed more from fertility tourism than from competition within a single geographic region. The largest challenge may be linking those who would fund innovation, whether innovation that produces new high …

Hospital Mergers And Economic Efficiency, Roger D. Blair, Christine Piette Durrance, D. Daniel Sokol

Washington Law Review

Consolidation via merger both from hospital-to-hospital mergers and from hospital acquisitions of physician groups is changing the competitive landscape of the provision of health care delivery in the United States. This Article undertakes a legal and economic examination of a recent Ninth Circuit case examining the hospital acquisition of a physician group. This Article explores the Saint Alphonsus Medical Center-Nampa Inc. v. St. Luke’s Health System, Ltd. (St. Luke’s) decision—proposing a type of analysis that the district court and Ninth Circuit should have undertaken and that we hope future courts undertake when analyzing mergers in the health care …

The Law, Economics, And Medicine Of Off-Label Prescribing, William S. Comanor, Jack Needleman

Washington Law Review

There is a major dissonance in the current structure of regulating new drugs that have more than one medical indication. Physicians are authorized to prescribe these drugs for all indications including those beyond their approved purposes. However, product manufacturers are expressly prohibited from marketing or promoting their drugs for any purpose other than those which have been specifically indicated. While prescribing physicians are encouraged to gain medical information on any additional indications, they cannot obtain it from one of its most likely sources: the drug’s supplier. The Second Circuit Court of Appeals’ recent opinion in United States v. Caronia has …

Contraceptive Coverage Falls, No More: Using Rfra To Limit The Scope Of Religious Challenges To The Aca's Contraceptive Mandate, M. Catherine Norman

Mercer Law Review

Contraceptive coverage is a required part of all new insurance plans under the Patient Protection and Affordable Care Act (ACA), but many employers' are exempt from this requirement. Other employers have challenged the contraceptive requirement on religious grounds. In East Texas Baptist University v. Burwell, the United States Court of Appeals for the Fifth Circuit held as follows: (1) the plaintiffs are either automatically exempt from the contraceptive-coverage mandate or eligible for accommodation upon application; (2) the challenged provisions do not violate rights to religious freedom under the Religious Freedom and Restoration Act (RFRA); (3) RFRA applies only to …

The Fatality And Morbidity Components Of The Value Of Statistical Life, W. Kip Viscusi, Elissa Philip Gentry

Vanderbilt Law School Faculty Publications

The fatality risk–money tradeoff that is the value of a statistical life (VSL) may vary with the nature of the fatality event. While all fatalities involve loss of future life expectancy, the morbidity effects and their duration may differ. This article analyzes fatality risks accompanied by morbidity effects of different duration to disentangle the mortality and morbidity components of VSL using data from the Census of Fatal Occupational Injuries (CFOI). The VSL is comprised of the sum of the value of the fatality risk and the value of the morbidity risk. Labor market valuations of morbidity risks are positive, even …

Byrne: Closing The Gap Between Hipaa And Patient Privacy, Austin Rutherford

San Diego Law Review

HIPAA’s lack of an individualized remedy harmed individuals and left the law a toothless monster, but Byrne begins to fill the longstanding gap by offering greater protection for individuals and their sensitive information. Byrne will also incentivize better compliance with HIPAA by instilling in companies a fear of sizeable tort suit damage awards.

Part II of this Note introduces HIPAA and its ability to protect sensitive health information. Part III discusses the facts, holding, and reasoning of Byrne, in which a state supreme court, for the first time, recognized HIPAA requirements as a duty owed in negligence claims. Part IV …

A Liberal Dilemma: Respecting Autonomy While Also Protecting Inchoate Children From Prenatal Substance Abuse., Andrew J. Weisberg, Frank E. Vandervort

Articles

Substance abuse is a significant social problem in America. It is estimated that some eighteen million Americans have an alcohol abuse problem and that almost five million have a drug abuse problem. According to the National Institute on Drug Abuse, substance abuse costs some $700 billion per year Substance abuse is a major contributor to child maltreatment. It is estimated that between one- and two-thirds of cases in which children enter foster care are linked to parental substance abuse. Unfortunately, this may be an underestimate as recent research suggests that many cases, particularly cases in which children have been exposed …

Monitoring Hiv And Aids Related Policy Reforms: A Road Map To Strengthen Policy Monitoring And Implementation In Pepfar Partner Countries, Jeffrey Lane, Andre Verani, Mai Hijazi, Erin Hurley, Amy Hagopian, Nicole Judice, Ron Macinnis, Sallie Sanford, Sarah Zelek, Aaron Katz

Articles

Achieving an AIDS-free generation will require the adoption and implementation of critical health policy reforms. However, countries with high HIV burden often have low policy development, advocacy, and monitoring capacity. This lack of capacity may be a significant barrier to achieving the AIDS-free generation goals. This manuscript describes the increased focus on policy development and implementation by the United States President’s Emergency Plan for AIDS Relief (PEPFAR). It evaluates the curriculum and learning modalities used for two regional policy capacity building workshops organized around the PEPFAR Partnership Framework agreements and the Road Map for Monitoring and Implementing Policy Reforms. …