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Health Law and Policy Commons

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Medicine and Health Sciences

2016

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Articles 1 - 30 of 116

Full-Text Articles in Health Law and Policy

Quintavalle: The Quandary In Bioethics, Lisa Cherkassky Dec 2016

Quintavalle: The Quandary In Bioethics, Lisa Cherkassky

Journal of Law and Health

The case of R. (Quintavalle) v. Human Fertilisation Embryology Authority (and Secretary of State for Health) presents a handful of legal problems. The biggest legal query to arise from the case is the inevitable harvest of babies, toddlers and very young children for their bone marrow. This article unpacks the judicial story behind Quintavalle to reveal how the strict provisions of the Human Fertilisation and Embryology Act 1990 - namely ‘suitable condition’ under schedule 2 paragraph 1(1)(a) and ‘treatment services’ and ‘assisting’ under section 2(1) - were widely misinterpreted to introduce the social selection of embryos into law. The ...


Healer, Witness, Or Double Agent? Reexamining The Ethics Of Forensic Psychiatry, Matthew U. Scherer Dec 2016

Healer, Witness, Or Double Agent? Reexamining The Ethics Of Forensic Psychiatry, Matthew U. Scherer

Journal of Law and Health

In recent years, psychiatrists have become ever more prevalent in American courtrooms. Consequently, the issue of when the usual rules of medical ethics should apply to forensic psychiatric encounters has taken on increased importance and is a continuing topic of discussion among both legal and medical scholars. A number of approaches to the problem of forensic psychiatric ethics have been proposed, but none adequately addresses the issues that arise when a forensic encounter develops therapeutic characteristics. This article looks to the rules governing the lawyer-client relationship as a model for a new approach to forensic psychiatric ethics. This new model ...


Mending Invisible Wounds: The Efficacy And Legality Of Mdma-Assisted Psychotherapy In United States' Veterans Suffering With Post-Traumatic Stress Disorder, Jonathan Perry Dec 2016

Mending Invisible Wounds: The Efficacy And Legality Of Mdma-Assisted Psychotherapy In United States' Veterans Suffering With Post-Traumatic Stress Disorder, Jonathan Perry

Journal of Law and Health

Though Veteran Affairs has provided crucial life sustaining—and often lifesaving—treatments to returning soldiers, the substantial and ever-increasing rates of veteran suicides, drug addictions, and criminal behavior indicate a need for broader options in treatment. One of the most profound discoveries uncovered through MDMA-assisted psychotherapy research is MDMA’s facilitation of the alleviation of addictive behavior in subjects, and, as a result, an alleviation of addictions in general. Addiction is one of the key symptoms of post-traumatic stress disorder (PTSD) and drug abuse plays a large role in the other afflictions suffered by veterans, namely criminal activity and a ...


Southern New England Practice Transformation Network: Thinking Outside The Box Solved Our Enrollment Challenges, David Polakoff Dec 2016

Southern New England Practice Transformation Network: Thinking Outside The Box Solved Our Enrollment Challenges, David Polakoff

Commonwealth Medicine Publications

The strategies used by the Southern New England Practice Transformation Network (SNE-PTN), a collaborative led by UMass Medical School and UConn Health, to enroll more than 5,000 clinicians from a variety of specialties by the end of October 2016. The strategies led SNE-PTN to achieve 186 percent of the year one enrollment target.

SNE-PTN is one of 29 practice transformation networks across the country chosen by the Centers for Medicare and Medicaid Services to be part of its Transforming Clinical Practices Initiative. This practice transformation program aims to bring together specialty and primary care clinicians to work individually and ...


Quality Of Death People With Terminal Illnesses Are Turning To An Age-Old Method To End It All: Self-Starvation, Kazi E. Awal, Alyssa Pagano Dec 2016

Quality Of Death People With Terminal Illnesses Are Turning To An Age-Old Method To End It All: Self-Starvation, Kazi E. Awal, Alyssa Pagano

Capstones

Voluntarily stopping eating and drinking (VSED) is getting more attention in the medical community. Though physician assisted dying legislation passed in two more states in 2016--there are now 7 states where it is legal--the practice, where doctors prescribe a lethal dose of sedatives so that terminally ill patients can end their own lives, is inaccessible to many. But fasting to death is a way for patients suffering from terminal illnesses or other debilitating diseases to end their lives on their own terms that is legal everywhere. As extreme as it sounds, research shows the process can be made comfortable with ...


Pipeline Trends December 2016, Timothy Cummins Dec 2016

Pipeline Trends December 2016, Timothy Cummins

Commonwealth Medicine Publications

Pipeline Trends is produced by UMass Medical School’s Clinical Pharmacy Services division and is distributed at least once a year. This edition provides a comprehensive overview of:

  • Promising New Agents: Abaloparatide, Cannabidiol, Dupilumab, and others
  • Projected Generic Entry: Strattera®, Tamiflu®, Truvada®, Zetia®, and others
  • Investigational Indications: Cabozantinib and Tofacitinib
  • FDA Updates
  • Industry Trends


Self-Direction In Managed Long Term Services And Supports, Jessica Carpenter Dec 2016

Self-Direction In Managed Long Term Services And Supports, Jessica Carpenter

Commonwealth Medicine Publications

Learn about the concept of self-direction in Managed Long-Term Services and Supports, including its origin and characteristics and individual and caregiver perspectives. Also presented are health plan considerations, suggestions, and best practices.


Improving Community Health Through Hospital Community Benefit Spending: Charting A Path To Reform, Sara J. Rosenbaum, Maureen Byrnes, Sara Rothenberg, Rachel Gunsalus Dec 2016

Improving Community Health Through Hospital Community Benefit Spending: Charting A Path To Reform, Sara J. Rosenbaum, Maureen Byrnes, Sara Rothenberg, Rachel Gunsalus

Health Policy and Management Faculty Publications

No abstract provided.


Planning For The 2017 Specialty Drug Spend: When Costs Are Steep But Pockets Are Not Deep, Nicole M. Trask Nov 2016

Planning For The 2017 Specialty Drug Spend: When Costs Are Steep But Pockets Are Not Deep, Nicole M. Trask

Commonwealth Medicine Publications

Specialty drug spend increased by 15 percent to $121 billion in 2015 and is projected to rise even more. Budget-conscious payers need to implement novel management strategies that anticipate the cost of specialty medications before they’re available. A summary of efficacy data for high-impact specialty pipeline drugs expected to reach the market, including their place in therapy and budgetary impact. Also featured are strategies to mitigate costs of these cutting-edge medications and compare them to current therapy options.


Waiver World: A Guided Tour Of 1115 And 1332 Waivers, Jean C. Sullivan, Marybeth Mccaffrey, Rachel Gershon, Josh Krintzman Nov 2016

Waiver World: A Guided Tour Of 1115 And 1332 Waivers, Jean C. Sullivan, Marybeth Mccaffrey, Rachel Gershon, Josh Krintzman

Commonwealth Medicine Publications

An overview of waivers made possible by Section 1115 of the Social Security Act and Section 1332 of the Affordable Care Act. This presentation explains spending and waiver authority and the legal considerations that may arise, the ways that states have used waiver authority, and reviews the limitations and new responsibilities that come with waivers.

Under Section 1115 of the Social Security Act, states can pursue waivers to implement pilot or demonstration projects affecting many programs, including Medicaid. Under the Affordable Care Act, Section 1332 allows states to pursue federal waivers for innovation strategies that will expand access to high-quality ...


Issues And Challenges: The Development Of Fair And Equitable Health Policy, Rachele Hendricks-Sturrup Nov 2016

Issues And Challenges: The Development Of Fair And Equitable Health Policy, Rachele Hendricks-Sturrup

Internet Journal of Allied Health Sciences and Practice

Public health policy/law is a discipline that seeks to identify opportunities and implement mechanisms to achieve justice in the public health sector. Several public health policies and programs have been implemented by virtue of the Affordable Care Act (ACA), and these policies and programs seek to decrease America’s “paradox of excess and deprivation” and address socioeconomic barriers that exist in the U.S. healthcare system. Private healthcare market interests have accused the ACA of intruding heavily into the professional autonomy of the medical profession, eroding healthcare market competition, and driving up national healthcare spending. Counter-arguments defending the ACA ...


Sustainable Financing Models For Community Health Worker Services In Maine, Katharine London, Kelly Love, Roosa Tikkanen Nov 2016

Sustainable Financing Models For Community Health Worker Services In Maine, Katharine London, Kelly Love, Roosa Tikkanen

Commonwealth Medicine Publications

UMass Medical School health policy experts have developed sustainable financing models for the state of Maine to support four community health worker (CHW) interventions that focus on patients with the greatest, and most costly, health care needs.

The report examines academic literature documenting results obtained by CHW interventions in other parts of the country, calculates the outcomes that could be achieved if the same interventions were implemented in Maine, and provides budget specifications needed to achieve those outcomes

Using actual population and cost data from Maine, interviews with Maine CHWs and features of CHW interventions operating in other states, the ...


A Comprehensive Review Of The 2016 Asha Code Of Ethics, Robin L. Edge Ph.D., Ccc-Slp, Bess Sirmon-Taylor Ph.D., Ccc-Slp, Raul F. Prezas Ph.D., Ccc-Slp Oct 2016

A Comprehensive Review Of The 2016 Asha Code Of Ethics, Robin L. Edge Ph.D., Ccc-Slp, Bess Sirmon-Taylor Ph.D., Ccc-Slp, Raul F. Prezas Ph.D., Ccc-Slp

Journal of Human Services: Training, Research, and Practice

The American Speech-Language-Hearing Association (ASHA) initially implemented a Code of Ethics in 1952, and has periodically revisited the content of the document with revisions to reflect the expanding scope of practice within speech-language pathology and audiology and to clarify certain concepts. Code revision is a cyclical mandated task of the ASHA Board of Ethics conducted to assure accuracy, currency, and completeness of this most important document (Solomon-Rice & O’Rourke, 2016). The current version of the Code of Ethics (2016) was modified from the previous version (2010r), with an updated preamble, definitions of related vocabulary, and re-organized language in the principles ...


Complex Care Management Model Design, Jessica Carpenter Oct 2016

Complex Care Management Model Design, Jessica Carpenter

Commonwealth Medicine Publications

The steps to developing Complex Care Management Model Design for state Medicaid programs with a focus on one single point of entry. In this design, long term services and supports are provided in order for individuals to remain in the community.


Best Practices In Care Coordination & Transitions Of Care Communications, Jessica Carpenter Oct 2016

Best Practices In Care Coordination & Transitions Of Care Communications, Jessica Carpenter

Commonwealth Medicine Publications

Learn the strategies required to deliver patient-centric, quality care for individuals with complex care needs. Successful coordination and management requires networking with multiple care providers and linking each intervention to the individual’s overall care.


Community Health Centers And Medicaid Payment Reform: Emerging Lessons From Medicaid Expansion States, Peter Shin, Jessica Sharac, Zoe Barber, Sara J. Rosenbaum Oct 2016

Community Health Centers And Medicaid Payment Reform: Emerging Lessons From Medicaid Expansion States, Peter Shin, Jessica Sharac, Zoe Barber, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Community health centers represent a major source of primary health care for the nation’s Medicaid beneficiaries. Because the Federally Qualified Health Center (FQHC) payment system is encounter-based, health centers and Medicaid agencies in ACA expansion states are actively pursuing payment reforms that will enable health centers to adopt strategies that can more effectively respond to the considerable and complex health and social needs of people served by health centers, and more efficiently address the surging volume of patient care. In five expansion states whose alternative payment experiments are underway, health centers and Medicaid agencies are testing payment alternatives, such ...


Getting Started In Your Neighborhood: Piloting Community Health Teams Through A Multi-Payer Approach, Susanne Campbell, Roberta Goldman, Scott Hewitt Oct 2016

Getting Started In Your Neighborhood: Piloting Community Health Teams Through A Multi-Payer Approach, Susanne Campbell, Roberta Goldman, Scott Hewitt

Commonwealth Medicine Publications

The Care Transformation Collaborative of Rhode Island (CTC), a patient-centered medical home initiative managed by UMass Medical School, explains how primary care practices can build a medical neighborhood by creating a community health team to provide behavioral health and social support services to patients with high-cost, complex care needs. CTC used a multi-payer approach to pilot and evaluate two community health teams in two diverse areas of Rhode Island.


Health It Security: An Examination Of Modern Challenges In Maintaining Hipaa And Hitech Compliance, Andrew S. Miller, Bryson R. Payne Oct 2016

Health It Security: An Examination Of Modern Challenges In Maintaining Hipaa And Hitech Compliance, Andrew S. Miller, Bryson R. Payne

KSU Proceedings on Cybersecurity Education, Research and Practice

This work describes an undergraduate honors research project into some of the challenges modern healthcare providers face in maintaining compliance with the Health Insurance Portability and Accountability Act (HIPAA) and HITECH (Health Information Technology for Economic and Clinical Health) Act. An overview of the pertinent sections of both the HIPAA and HITECH Acts regarding health information security is provided, along with a discussion of traditionally weak points in information security, including: people susceptible to social engineering, software that is not or cannot be regularly updated, and targeted attacks (including advanced persistent threats, or APTs). Further, the paper examines potential violations ...


Mid-Atlantic Ethics Committee Newsletter, Fall 2016 Oct 2016

Mid-Atlantic Ethics Committee Newsletter, Fall 2016

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.


Financial Hardship From Purchasing Medications For Senior Citizens Before And After The Medicare Modernization Act Of 2003 And The Patient Protection And Affordable Care Act Of 2010: Findings From 1998, 2001, And 2015, Anthony W. Olson, Jon C. Schommer, David A. Mott, Lawrence M. Brown Oct 2016

Financial Hardship From Purchasing Medications For Senior Citizens Before And After The Medicare Modernization Act Of 2003 And The Patient Protection And Affordable Care Act Of 2010: Findings From 1998, 2001, And 2015, Anthony W. Olson, Jon C. Schommer, David A. Mott, Lawrence M. Brown

Pharmacy Faculty Articles and Research

BACKGROUND: The Medicare Modernization Act of 2003 (Medicare Part D) added prescription drug coverage for senior citizens aged 65 years and older and applied managed care approaches to contain costs. The Patient Protection and Affordable Care Act of 2010 (ACA) had the goals of expanding health care insurance coverage and slowing growth in health care expenditures.

OBJECTIVES: To (a) describe the proportion of senior citizens who had prescription drug insurance coverage and the proportion who experienced financial hardship from purchasing medications in 2015, and (b) compare the findings with those collected in 1998 and 2001.

METHODS: Data were obtained in ...


Emergency Medical Services And Public Policy In Durban, Kwazulu-Natal, John Buyske Oct 2016

Emergency Medical Services And Public Policy In Durban, Kwazulu-Natal, John Buyske

Independent Study Project (ISP) Collection

This project seeks to explore the realities of the emergency medical system in the Durban area, particularly relative to government policy. It contextualizes its findings within the literature on public policy. Data for the project was collected via nine in-depth interviews with various professionals working in the field of emergency medical services, as well as a survey of fourteen citizens conducted in the peri-urban township of Cato Manor. This data was analyzed using qualitative methods. While every participant had different views and a different perspective on emergency services, some recurring themes and trends became evident, allowing for conclusions to be ...


Zika Virus And Global Health Security, Lawrence O. Gostin, James G. Hodge Jr. Oct 2016

Zika Virus And Global Health Security, Lawrence O. Gostin, James G. Hodge Jr.

Georgetown Law Faculty Publications and Other Works

Americans are largely apathetic about the risks of Zika virus and Congress cannot agree on preparedness funding. Strategies to counter the spread of Zika by the World Health Organisation (WHO) grossly underestimate the disease’s impact. WHO and member countries lack sufficient resources to respond. Consequences of fiscal apathy can be measured in lives lost and long-term disabilities. Zika prevention is a matter of global health security.

The epidemiologic brunt of Zika in South America falls largely on vulnerable women at heightened risk of exposure through mosquitoes and sexual transmission. Resulting transmission to fetuses and infants will have generational impacts ...


Care Transformation Collaborative Rhode Island: Transforming Primary Care In Rhode Island, Susanne Campbell, Sarah Dell, Michael Mobilio, Michele Brown, Candice Brown Sep 2016

Care Transformation Collaborative Rhode Island: Transforming Primary Care In Rhode Island, Susanne Campbell, Sarah Dell, Michael Mobilio, Michele Brown, Candice Brown

Commonwealth Medicine Publications

This annual report outlines the 2015 accomplishments of Care Transformation Collaborative (CTC) Rhode Island, a primary care initiative managed by UMass Medical School. CTC includes more than 80 primary care practices across the state.

In 2015 CTC had many achievements, including:

  • Improving the cost of care and efficiency – through new programs like our Advanced Collaborative, practices developed and implemented projects focused on improving quality and reducing costs of care.
  • Evaluating, refining and scaling our Community Health Teams – we evaluated the progress of these pilot programs and look forward to building off their successes and lessons learned.
  • Expanding to include additional ...


Resource Guide For Addiction And Mental Health Care Consumers: Answering Questions About Insurance Coverage And Parity For Addiction And Mental Health Care Services, Lucy C. Hodder, Michele D. Merritt, Margaret H. Schmidt, Jacqueline Botchman, Caitlyn Ebert, Marguerite Corvini, Kate Crary, Bridget Drake Sep 2016

Resource Guide For Addiction And Mental Health Care Consumers: Answering Questions About Insurance Coverage And Parity For Addiction And Mental Health Care Services, Lucy C. Hodder, Michele D. Merritt, Margaret H. Schmidt, Jacqueline Botchman, Caitlyn Ebert, Marguerite Corvini, Kate Crary, Bridget Drake

Law Faculty Scholarship

Navigating the maze of health insurance coverage can be difficult. For individuals with addiction or mental illness, the process of getting treatment approved and paid for by health insurance can be overwhelming. As a result, many people give up when their health insurance company denies coverage for needed services. This Guide can help people learn how to access health insurance and use their coverage to pay for treatment. This Guide also provides a basic explanation of consumers’ rights under the federal Mental Health Parity and Addiction Equity Act.


Neuroethics: Neurolaw, Stephen J. Morse Sep 2016

Neuroethics: Neurolaw, Stephen J. Morse

Faculty Scholarship at Penn Law

This is a pre-copyedited version of a chapter in the Oxford Handbooks Online (Philosophy) edited by Sandy Goldberg. In altered form, it was published online in February, 2017 and can be found at the Oxford Handbooks Online website. The entry discusses whether the findings of the new neuroscience based largely on functional brain imaging raise new normative questions and entail normative conclusions for ethical and legal theory and practice. After reviewing the source of optimism about neuroscientific contributions and the current scientific status of neuroscience, it addresses a radical challenge neuroscience allegedly presents: whether neuroscience proves persons do not have ...


The Pediatric Behavioral Health Medication Initiative, Neha Kashalikar Sep 2016

The Pediatric Behavioral Health Medication Initiative, Neha Kashalikar

Commonwealth Medicine Publications

How the Massachusetts Medicaid Pharmacy Program, which is managed by UMass Medical School, developed the Pediatric Behavioral Health Medication Initiative. The initiative was created in response to studies and reports that found pediatric behavioral health medication polypharmacy regimes had been increasing. Compared to the rest of the country, the prevalence was highest among the MassHealth pediatric population.

A prior authorization requirement, guidelines, case review and a prescriber outreach process were established as part of the initiative to ensure MassHealth pediatric members were being prescribed appropriate behavioral health medication.


Smoking On The Margins: A Comprehensive Analysis Of A Municipal Outdoor Smoke-Free Policy, Ann Pederson, Chizimuzo T. C. Okoli, Natalie Hemsing, Renée O'Leary, Amanda T. Wiggins, Wendy Rice, Joan L. Bottorff, Lorraine Greaves Aug 2016

Smoking On The Margins: A Comprehensive Analysis Of A Municipal Outdoor Smoke-Free Policy, Ann Pederson, Chizimuzo T. C. Okoli, Natalie Hemsing, Renée O'Leary, Amanda T. Wiggins, Wendy Rice, Joan L. Bottorff, Lorraine Greaves

Nursing Faculty Publications

Background: This study examined the formulation, adoption, and implementation of a ban on smoking in the parks and beaches in Vancouver, Canada.

Methods: Informed by Critical Multiplism, we explored the policy adoption process, support for and compliance with a local bylaw prohibiting smoking in parks and on beaches, experiences with enforcement, and potential health equity issues through a series of qualitative and quantitative studies.

Results: Findings suggest that there was unanimous support for the introduction of the bylaw among policy makers, as well as a high degree of positive public support. We observed that smoking initially declined following the ban ...


Improving Population Healthcare Through Data Analytics, Visualization, And Reporting Tools, Rick Perro Aug 2016

Improving Population Healthcare Through Data Analytics, Visualization, And Reporting Tools, Rick Perro

Commonwealth Medicine Publications

Policy makers, program planners and health care providers must be able to identify at-risk populations and geographic areas of need, implement programs to effect change, and track and report the results to achieve success in today’s health care environment. Mapping and visualization tools can enhance the use of data to characterize a population’s health and social services needs, target interventions and compare outcomes across different population subgroups. In Massachusetts, visualization and analytic tools are used to manage 1915c Medicaid Waiver programs, track operations, improve efficiency, report quality measures, monitor program integrity and plan for expanded service needs.


A Pathway To Dual Eligible Data Integration: Maximizing Coordination Of Benefits, Services, And Payments Through The Massachusetts Mmis, Jenifer Hartman, Kathleen Melanson Aug 2016

A Pathway To Dual Eligible Data Integration: Maximizing Coordination Of Benefits, Services, And Payments Through The Massachusetts Mmis, Jenifer Hartman, Kathleen Melanson

Commonwealth Medicine Publications

We have partnered with MassHealth, Massachusetts’ Medicaid program, to develop and deploy precision data integration methodologies within the Massachusetts Medicaid Management Information System (MMMIS) to maximize coordination of benefits, services and payments for Medicaid recipients with current or potential dual eligibility for Medicare. Integration strategies and coordination benchmarks are used to ensure accurate Medicaid and Medicare enrollment; fully engage service delivery options (including managed care and integrated care programs); and effectively cost-avoid, reprice, or cost-share to ensure the state’s lowest payment liability.


Implementation Of The Affordable Care Act In Physical Therapy, Greg Austin Aug 2016

Implementation Of The Affordable Care Act In Physical Therapy, Greg Austin

Honors College Capstone Experience/Thesis Projects

Introduction: With the implementation of the Affordable Care Act (ACA) in 2010, many medical specialties prepared to see reimbursement rates altered. Not impervious to this trend was the field of physical therapy (PT). This change in reimbursement structure could impact the effectiveness of PT treatment. Under this model, a patient may not be able to receive the appropriate number of visits to a physical therapist, resulting in a loss of utilization in the injured area and, possibly, a loss of independence. Methods: A literature review was performed to determine reimbursement rate impact on PT. A seven-item open-ended survey regarding various ...