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Articles 1 - 30 of 425

Full-Text Articles in Health Law and Policy

Table Of Contents, Seattle University Law Review Sep 2019

Table Of Contents, Seattle University Law Review

Seattle University Law Review

No abstract provided.


Humanizing Work Requirements For Safety Net Programs, Mary Leto Pareja Sep 2019

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 ...


Humanizing Work Requirements For Safety Net Programs, Mary Leto Pareja Sep 2019

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 ...


The Kids Are Not Alright: Leveraging Existing Health Law To Attack The Opioid Crisis Upstream, Yael Cannon Jul 2019

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 ...


Moving Beyond Medical Debt, Brook E. Gotberg, Michael D. Sousa Jul 2019

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 ...


Health Care's Market Bureaucracy, Allison K. Hoffman May 2019

Health Care's Market Bureaucracy, Allison K. Hoffman

Faculty Scholarship at Penn Law

The last several decades of health law and policy have been built on a foundation of economic theory. This theory supported the proliferation of market-based policies that promised maximum efficiency and minimal bureaucracy. Neither of these promises has been realized. A mounting body of empirical research discussed in this Article makes clear that leading market-based policies are not efficient — they fail to capture what people want. Even more, this Article describes how the struggle to bolster these policies — through constant regulatory, technocratic tinkering that aims to improve the market and the decision-making of consumers in it — has produced a massive ...


The Impact Of H.B. 214: A Critical Analysis Of The Texas "Rape Insurance" Bill, Lucie Arvallo Apr 2019

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 ...


An Implied Defense: Self-Disclosure Offers A Defense To The Expanded False Claims Liability After Universal Health Services V. Escobar, Megan E. Italiano Apr 2019

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.


Table Of Contents, Seattle University Law Review Feb 2019

Table Of Contents, Seattle University Law Review

Seattle University Law Review

No abstract provided.


The Failed Promise Of Mental Health Parity In Virginia: A Missing Key In Mental Healthcare Access, Zachary Woerner Feb 2019

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 ...


How Liability Insurers Protect Patients And Improve Safety, Tom Baker, Charles Silver Jan 2019

How Liability Insurers Protect Patients And Improve Safety, Tom Baker, Charles Silver

Faculty Scholarship at Penn Law

Forty years after the publication of the first systematic study of adverse medical events, there is greater access to information about adverse medical events and increasingly widespread acceptance of the view that patient safety requires more than vigilance by well-intentioned medical professionals. In this essay, we describe some of the ways that medical liability insurance organizations contributed to this transformation, and we catalog the roles that those organizations play in promoting patient safety today. Whether liability insurance in fact discourages providers from improving safety or encourages them to protect patients from avoidable harms is an empirical question that a survey ...


State Benchmark Plan Coverage Of Opioid Use Disorder Treatments And Services: Trends And Limitations, Stacey A. Tovino Jan 2019

State Benchmark Plan Coverage Of Opioid Use Disorder Treatments And Services: Trends And Limitations, Stacey A. Tovino

Scholarly Works

Professor Tovino offers a survey of state benchmark plan coverage of opioid use disorder treatments and services, and identifies trends and limitations relevant thereto. Part II of the article provides background information regarding opioid use disorder and the treatments and services available for individuals with this disorder. Part III reviews federal mental health parity law and federal mandatory mental health and substance use disorder law as applied to insurance coverage of treatments and services for opioid use disorder, with a focus on the Affordable Care Act's (ACA's) state benchmark health plan selection requirement and the effect on that ...


Does Small Group Health Insurance Deliver Group Benefits? An Argument In Favor Of Allowing The Small Group Market To Die, John Aloysius Cogan Jr. Oct 2018

Does Small Group Health Insurance Deliver Group Benefits? An Argument In Favor Of Allowing The Small Group Market To Die, John Aloysius Cogan Jr.

Washington Law Review

The small group health insurance market is failing. Today, fewer than one-third of small firms now offer health insurance and the number of people covered by small group insurance continues to drop. These problems invite the obvious question: What should be done about the small group market? Past scholarship on the small group market has largely focused on documenting the market’s problems, evaluating the effectiveness of prior reform efforts, and proposing regulatory changes to stabilize the market. This Article takes a different approach to the small group problem by asking a previously unasked question: Does the small group market ...


The Duality Of Provider And Payer In The Current Healthcare Landscape And Related Antitrust Implications, Julia Kapchinskiy Oct 2018

The Duality Of Provider And Payer In The Current Healthcare Landscape And Related Antitrust Implications, Julia Kapchinskiy

San Diego Law Review

Health care landscape has changed with the introduction of the ACA and will keep changing due to the proposed repeal. The only constant is the desire of health plans and providers to maximize profits and minimize costs, which is attainable through consolidation. This Comment advocates a revision of the existing antitrust guidelines that would (1) recognize unique nature of health care market, (2) be independent from the current or proposed legislation to the maximum possible extent, and (3) reflect the insurer-provider duality, which heavily influences the quality and accessibility of the healthcare for the consumer.


Reform At Risk — Mandating Participation In Alternative Payment Plans, Scott Levy, Nicholas Bagley, Rahul Rajkumar May 2018

Reform At Risk — Mandating Participation In Alternative Payment Plans, Scott Levy, Nicholas Bagley, Rahul Rajkumar

Articles

In an ambitious effort to slow the growth of health care costs, the Affordable Care Act created the Center for Medicare and Medicaid Innovation (CMMI) and armed it with broad authority to test new approaches to reimbursement for health care (payment models) and delivery-system reforms. CMMI was meant to be the government’s innovation laboratory for health care: an entity with the independence to break with past practices and the power to experiment with bold new approaches. Over the past year, however, the Department of Health and Human Services (HHS) has quietly hobbled CMMI, imperiling its ability to generate meaningful ...


"Thou Shalt Not Ration Justice": The Importance Of Autism Insurance Reform For Military Autism Families, And The Economic And National Security Implications Of Improving Access To Aba Therapy Under Tricare, Ariana Cernius Apr 2018

"Thou Shalt Not Ration Justice": The Importance Of Autism Insurance Reform For Military Autism Families, And The Economic And National Security Implications Of Improving Access To Aba Therapy Under Tricare, Ariana Cernius

Journal of Legislation

No abstract provided.


The Challenges Of Conscience In A World Of Compromise, Amy J. Sepinwall Jan 2018

The Challenges Of Conscience In A World Of Compromise, Amy J. Sepinwall

Legal Studies and Business Ethics Papers

The process of crafting and passing legislation might be thought to be the locus of compromise par excellence.1 Yet, where the law that results impinges upon moral or religious belief or practice, the issue of compromise arises anew, in both senses of the word: Individuals who oppose the law on moral or religious grounds believe that their political obedeience will compromise them in a fundamental way. Their plea for an exemption from the objectionable legal requirement is, then, a bid for further compromise.2 Compromise in the first sense concerns an undercutting of the self, while compromise in the ...


Consumer Financial Protection In Health Care, Erin C. Fuse Brown Oct 2017

Consumer Financial Protection In Health Care, Erin C. Fuse Brown

Erin C. Fuse Brown

There are inadequate consumer protections from harmful medical billing practices that result in unavoidable, unexpected, and often financially devastating medical bills. The problem stems from the increasing costs shifting to patients in American health care and the inordinate complexity that makes health care transactions nearly impossible for consumers to navigate. A particularly outrageous example is the phenomenon of surprise medical bills, which refers to unanticipated and involuntary out-of-network bills in emergencies or from out-of- network providers at in-network facilities. Other damaging medical billing practices include the opaque and à la carte nature of medical bills, epitomized by added “facility fees ...


Reading Alexander V. Choate Rightly: Now Is The Time, Leslie Francis, Anita Silvers Oct 2017

Reading Alexander V. Choate Rightly: Now Is The Time, Leslie Francis, Anita Silvers

Utah Law Faculty Scholarship

Whatever happens to the Affordable Care Act (ACA) over the next few years, it is fair to assume that state Medicaid programs will be subjected to cost control measures. Despite the recent deployment of substantial arguments to the contrary, the belief still persists that the Supreme Court’s decision in Alexander v. Choate over thirty years ago stands for the proposition that disability anti-discrimination law does not impose requirements on the structure of Medicaid benefits. This belief is misleading at best. In this article, we challenge the access/content distinction and the straitened interpretation of Alexander v. Choate that has ...


Anthem Health Plans Of Maine, Inc. V. Superintendent Of Insurance: Judicial Restraint Or Judicial Abdication?, David E. Sorensen Oct 2017

Anthem Health Plans Of Maine, Inc. V. Superintendent Of Insurance: Judicial Restraint Or Judicial Abdication?, David E. Sorensen

Maine Law Review

When Maine’s Superintendent of Insurance told the state’s largest health insurer that it could not profit in 2009, her decision ended up on appeal before the Maine Supreme Judicial Court, sitting as the Law Court, in Anthem Health Plans of Maine, Inc. v. Superintendent of Insurance. As part of its annual rate approval process, Anthem had requested a 3% profit and risk margin on its individual lines of health insurance in Maine. Superintendent Mila Kofman denied this request under her statutory authority to deny any rate increase proposals that are “excessive, inadequate or unfairly discriminatory.” The Superintendent held ...


Key New Hampshire And Federal Statutes Regulating Health Care Delivery And Payment, Lucy Hodder Oct 2017

Key New Hampshire And Federal Statutes Regulating Health Care Delivery And Payment, Lucy Hodder

Law Faculty Scholarship

A summary of New Hampshire and federal regulations by subject matter, chart of New Hampshire state agency responsibilities, federal laws and regulation: An index


Table Of Contents Oct 2017

Table Of Contents

Marquette Benefits and Social Welfare Law Review

No abstract provided.


Activation Measures In Social Security: Lessons From The Dutch Case Oct 2017

Activation Measures In Social Security: Lessons From The Dutch Case

Marquette Benefits and Social Welfare Law Review

Dutch social security has undergone important changes since the 1990s, in that the focus shifted from predominantly compensating the loss of income into giving incentives for claimants and benefits recipients to stay in or get back to work. While still providing a relatively high level of benefit if there is no chance to work (to the full extent), the legislature has been quite creative in adopting conditions that stimulate persons to do their best to be in work. For this purpose, this is interesting for an American audience, since the USA system is far less generous out of fear that ...


Erisa And Graham-Cassidy: A Disaster In Waiting For Employee Health Benefits And For Dependents Under 26 On Their Parents’ Plans, Leslie Francis Sep 2017

Erisa And Graham-Cassidy: A Disaster In Waiting For Employee Health Benefits And For Dependents Under 26 On Their Parents’ Plans, Leslie Francis

Utah Law Faculty Scholarship

Graham Cassidy § 105 would repeal the ACA “employer mandate”. Although its sponsors claim that the bill will give states a great deal of flexibility, it will do nothing to help states ensure that employers provide their employees with decent health insurance; quite the reverse. It will also give employers the freedom to ignore the popular ACA requirement that allows children up to age 26 to receive coverage through their parent’ plans, at least when their parents get health insurance from their employers. Here’s why.


Small Change, Big Consequences — Partial Medicaid Expansions Under The Aca, Adrianna Mcintyre, Allan M. Joseph, Nicholas Bagley Sep 2017

Small Change, Big Consequences — Partial Medicaid Expansions Under The Aca, Adrianna Mcintyre, Allan M. Joseph, Nicholas Bagley

Articles

Though congressional efforts to repeal and replace the Affordable Care Act (ACA) seem to have stalled, the Trump administration retains broad executive authority to reshape the health care landscape. Perhaps the most consequential choices that the administration will make pertain to Medicaid, which today covers more than 1 in 5 Americans. Much has been made of proposals to introduce work requirements or cost sharing to the program. But another decision of arguably greater long-term significance has been overlooked: whether to allow “partial expansions” pursuant to a state Medicaid waiver. Arkansas has already submitted a waiver request for a partial expansion ...


Covering The Care: Cost Sharing Reductions In Nh, Jo Porter, Lucy C. Hodder Jun 2017

Covering The Care: Cost Sharing Reductions In Nh, Jo Porter, Lucy C. Hodder

Law Faculty Scholarship

This brief uses national data to describe the NH population who received Cost Sharing Reductions for coverage on the NH Marketplace.


Covering The Care: A Focus On The Nh Marketplace, Jo Porter, Lucy C. Hodder Jun 2017

Covering The Care: A Focus On The Nh Marketplace, Jo Porter, Lucy C. Hodder

Law Faculty Scholarship

The second brief uses national and state data to describe the NH population enrolled in the health insurance plans through the NH Marketplace.


Covering The Care: Health Insurance Coverage In New Hampshire, Jo Porter, Lucy Hodder Jun 2017

Covering The Care: Health Insurance Coverage In New Hampshire, Jo Porter, Lucy Hodder

Law Faculty Scholarship

the first in a series of data and policy briefs that seek to inform the current conversations about health reform happening across the state. The first brief uses data from the American Community Survey to provide information about the health insurance coverage landscape in NH.


Deference To The Agency Is The Best Policy: The D.C. Circuit Applies Chevron In Denying Additional Medicare Reimbursements To Provider Hospitals In Washington Regional Medicorp, Brandon Curtin May 2017

Deference To The Agency Is The Best Policy: The D.C. Circuit Applies Chevron In Denying Additional Medicare Reimbursements To Provider Hospitals In Washington Regional Medicorp, Brandon Curtin

Boston College Law Review

On December 29, 2015, in Washington Regional Medicorp v. Burwell, the U.S. Court of Appeals for the District of Columbia Circuit held that the Secretary of Health and Human Services (“HHS”) correctly interpreted the Tax Equity and Fiscal Responsibility Act of 1982 (“TEFRA”) in calculating Medicare reimbursements for a provider hospital based on the capped target amount from the previous year. In agreeing with the Secretary, the D.C. Circuit joined the U.S. Courts of Appeals for the Third and Sixth Circuits in holding that the statute and its implementing regulations supported the Secretary. The U.S. Court ...


Can You Keep It? An Examination Of The Individual Health Insurance Market, Rachael Carnale May 2017

Can You Keep It? An Examination Of The Individual Health Insurance Market, Rachael Carnale

Honors Scholar Theses

The passage of the Patient Protection and Affordable Care Act (PPACA, ACA, or Obamacare) in 2010 significantly altered the structure of the individual health insurance market. The new regulatory environment and establishment of the health insurance exchanges forced insurers to adopt to be successful in the reformed individual market. However, the complexity of the law and uncertainty surrounding both the law itself and the newly insured have threatened the stability of the individual market. This thesis will explore the history of the individual health insurance market, the issues that current afflict the exchanges, and viability of possible solutions. Special attention ...