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Health Law and Policy Commons

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Full-Text Articles in Health Law and Policy

No Pay For Sexist Performance: How Gender Disparities In Healthcare Hurt Hospitals’ Pay For Performance Reimbursements, Emily C. Bartlett Jan 2018

No Pay For Sexist Performance: How Gender Disparities In Healthcare Hurt Hospitals’ Pay For Performance Reimbursements, Emily C. Bartlett

Washington University Law Review

Gender disparities and discrimination in healthcare treatment are vast. Women in pain are deemed hysterical, heart attacks in women are caught less frequently than in men due to symptom presentation differences, and women are screened less often than men for some cancers. Meanwhile, in order to be fully reimbursed for healthcare services, legislative reforms increasingly evaluate hospitals and physicians based on their performance as it relates to quality measurements, otherwise known as pay for performance. This particular method of reimbursement expanded after the Patient Protection and Affordable Care Act (ACA) enacted pay for performance standards, particularly for hospitals and physicians ...


Wrongly “Identified”: Why An Actual Knowledge Standard Should Govern Health Care Providers’ False Claims Act Obligations To Report And Return Medicare And Medicaid Overpayments, Nicholas J. Goldin Jan 2017

Wrongly “Identified”: Why An Actual Knowledge Standard Should Govern Health Care Providers’ False Claims Act Obligations To Report And Return Medicare And Medicaid Overpayments, Nicholas J. Goldin

Washington University Law Review

In 2015, Medicare spent $632 billion on health care for America’s elderly (and other covered groups). Medicaid spent another $554 billion to provide health care to America’s needy. The government estimates that improper payments account for as much as 10% of Medicare and Medicaid spending. Given the vast amount of money at stake, and the fact that there is bipartisan support for recovering taxpayer dollars, it is no surprise the federal government has made it a priority to recoup the money lost to health care fraud each year. The results are noticeable: annual recoveries for health care fraud ...


Alienage Classifications And The Denial Of Health Care To Dreamers, Fatma Marouf Jan 2016

Alienage Classifications And The Denial Of Health Care To Dreamers, Fatma Marouf

Washington University Law Review

In the Affordable Care Act (“ACA”), passed in 2010, Congress provided that only “lawfully present” individuals could obtain insurance through the Marketplaces established under the Act. Congress left it to the Department of Health and Human Services (“HHS”) to define who is “lawfully present.” Initially, HHS included all individuals with deferred action status, which is an authorized period of stay but not a legal status. After President Obama announced a new policy of Deferred Action for Childhood Arrivals (“DACA”) in June 2012, however, HHS amended its regulation specifically to exclude DACA recipients from the definition of “lawfully present.” The revised ...