Open Access. Powered by Scholars. Published by Universities.®

Health Law and Policy Commons

Open Access. Powered by Scholars. Published by Universities.®

Articles 1 - 12 of 12

Full-Text Articles in Health Law and Policy

The Tenuous Nature Of The Medicaid Entitlement, Timothy Stoltzfus Jost Sep 2015

The Tenuous Nature Of The Medicaid Entitlement, Timothy Stoltzfus Jost

Timothy S. Jost

Though Medicare was from the outset an entitlement under federal law, the status of Medicaid has always been less certain. Arguably, it was the Supreme Court, rather than Congress that first recognized that Medicaid recipients (and providers) could sue the states in federal court to enforce federal Medicaid requirements. A recent widely reported federal court decision, however, called radically into question the continuing existence of a federal Medicaid entitlement. Though this decision has now been reversed, and rejected by other courts, it illustrates the tenuous nature of the Medicaid entitlement, and the need to reconstitute Medicaid as an exclusively federal ...


Massachusetts Eligibility Data Platforms: Integrating State And Federal Data Sets To Maximize Benefits And Savings, Jenifer Hartman, Yuping Su Aug 2015

Massachusetts Eligibility Data Platforms: Integrating State And Federal Data Sets To Maximize Benefits And Savings, Jenifer Hartman, Yuping Su

Commonwealth Medicine Publications

This poster presentation shows how UMass Medical School works with state Medicaid programs to customize and implement business methodologies to maximize benefits for individuals and savings for states. The medical school’s collaboration with state and federal agencies has resulted in two national corrections of federal benefits systems in the past five years that led to increased benefits for individuals and increased Medicaid savings and revenue in all states.

Presented at the Medicaid Enterprise Systems Conference 2015.


State Differences In The Application Of Medical Frailty Under The Affordable Care Act, Peter Mosbach, Sherry Campanelli, A. E. Adams Jun 2015

State Differences In The Application Of Medical Frailty Under The Affordable Care Act, Peter Mosbach, Sherry Campanelli, A. E. Adams

Commonwealth Medicine Publications

This poster explains a study that examines how states undergoing Medicaid expansion differ in their treatment of the “medically frail” population. The medically frail are individuals who may need the extra benefits offered by traditional Medicaid.

The results provide needed information to policymakers that are interested in improving access among vulnerable populations in the 23 states that have not yet implemented Medicaid expansion, but may do so in the future. While regulations provide categories that qualify for medical frailty, each state is free to use their own method of determining who meets the definition. There is a need for ongoing ...


Assets, Costs, And Affordability: Why Magi-Based Medicaid Benefits Don't Account For True Need, Sara K. Hunkler May 2015

Assets, Costs, And Affordability: Why Magi-Based Medicaid Benefits Don't Account For True Need, Sara K. Hunkler

Indiana Journal of Law and Social Equality

In 2014, Mary, an asset-wealthy individual, will qualify for Medicaid ahead of Bob, a needier individual with less net wealth and significantly higher medical costs, solely because Bob’s income is slightly higher. The current income-based eligibility standards for Medicaid mandated by the Patient Protection and Affordable Care Act (PPACA) do not adequately reflect an individual’s need for federal assistance because they neglect to consider an individual’s assets, debts, and the circumstantial cost of their healthcare. Thus, these new federal standards permit significant disparities in the treatment of similarly situated impoverished individuals and allow prioritization of asset-wealthy individuals ...


Do Not Pass Go And Do Not Collect $200: Denying Medical Insurance To Parents Who Register Themselves Before Registering Their Children, Amanda Hamm May 2015

Do Not Pass Go And Do Not Collect $200: Denying Medical Insurance To Parents Who Register Themselves Before Registering Their Children, Amanda Hamm

William & Mary Journal of Race, Gender, and Social Justice

No abstract provided.


An Empirical Perspective On Medicaid As Social Insurance, Nicole Huberfeld, Jessica L. Roberts Apr 2015

An Empirical Perspective On Medicaid As Social Insurance, Nicole Huberfeld, Jessica L. Roberts

Law Faculty Scholarly Articles

This Essay begins to explore how Medicaid, after the Patient Protection and Affordable Care Act, metamorphoses from exclusion and limitations in access and benefits to a form of social insurance that implicates theories of social justice. The social justice aspect of universality provides an important lens for understanding these numbers, both in terms of the states that are expanding and the states that are opting out. States that refuse to expand their Medicaid programs are denying millions of Americans the benefit of a precious legal entitlement. It is essential that the states understand the power—and the potential—of this ...


How Proposed Husky Cuts Will Harm Low-Income Families, Rachel Gershon, Katharine London, Robert W. Seifert Mar 2015

How Proposed Husky Cuts Will Harm Low-Income Families, Rachel Gershon, Katharine London, Robert W. Seifert

Commonwealth Medicine Publications

An analysis of proposed Medicaid changes in Connecticut was conducted by our health policy experts. Using research literature and the recent experience of other states, we estimated the number of persons who would be left uninsured if the proposal is implemented, and discussed effects on access to care for parents, pregnant women, and children.


One State's Perspective On The Management Of Hepatitis C Drugs, Pavel Lavitas Feb 2015

One State's Perspective On The Management Of Hepatitis C Drugs, Pavel Lavitas

Commonwealth Medicine Publications

This presentation provides an overview of the hepatitis C virus monitoring program implemented for state Medicaid to contain costs and to promote optimal member care. Key clinical and economic outcomes of the monitoring program are highlighted and formulary management strategies for novel hepatitis C virus agents identified.

Presented at the American Drug Utilization Review Society 2015 Conference.


The Universality Of Medicaid At Fifty, Nicole Huberfeld Jan 2015

The Universality Of Medicaid At Fifty, Nicole Huberfeld

Law Faculty Scholarly Articles

This essay explores how the law of Medicaid after fifty years creates a meaningful principle of universalism by shifting from fragmentation and exclusivity to universality and inclusivity. The universality principle provides a new trajectory for all of American health care, one that is not based on individual qualities that are unrelated to medical care but rather grounded in non-judgmental principles of unification and equalization (if not outright solidarity). To that end, this Essay first will study the legislative reformation that led to universality and its quantifiable effects. The Essay then will assess and evaluate Medicaid’s new universality across four ...


Modernizing The Emergency Medical Treatment & Labor Act To Harmonize With The Affordable Care Act To Improve Equality, Quality And Cost Of Emergency Care, Katharine A. Van Tassel Jan 2015

Modernizing The Emergency Medical Treatment & Labor Act To Harmonize With The Affordable Care Act To Improve Equality, Quality And Cost Of Emergency Care, Katharine A. Van Tassel

Faculty Publications

The Emergency Medical Treatment and Active Labor Act (EMTALA) is a federal statute passed almost 30 years ago which was designed to ensure equal access to emergency treatment and to halt the practice of “patient dumping.” Patient dumping is a situation where some patients—typically uninsured, disabled, and minority individuals—receive inferior emergency medical care or are denied emergency medical treatment altogether. The goal of EMTALA is to ensure that everyone coming to the emergency room will receive equal care.

Unfortunately, despite EMTALA, the practice of patient dumping has continued to this day. The most recent case in the news ...


Will Uncooperative Federalism Survive Nfib?, Abigail Moncrieff, Jonathan Dinerstein Jan 2015

Will Uncooperative Federalism Survive Nfib?, Abigail Moncrieff, Jonathan Dinerstein

Faculty Scholarship

In October Term 2012, the Supreme Court decided two cases that are fundamentally at odds: NFIB v. Sebelius and Douglas v. Independent Living Center of Southern California. In NFIB, the Court held that the federal government, at least under some circumstances, may not use the threat of reduced funding in cooperative federalism programs to require states to comply with federal statutory requirements. In Douglas, however, the Court indicated that private litigants should sue federal agencies under the Administrative Procedure Act if those agencies refuse to enforce federal statutory requirements against the states. The problem is that the withdrawal of funding ...


The Reverberating Risk Of Long-Term Care, Allison K. Hoffman Jan 2015

The Reverberating Risk Of Long-Term Care, Allison K. Hoffman

Faculty Scholarship at Penn Law

The Fiftieth Anniversary of Medicare and Medicaid offers an opportunity to reflect on how American social policy has conceived of the problem of long-term care. In this essay, based on a longer forthcoming article, I argue that current policies adopt too narrow a conception of long-term care risk, by focusing on the effect of serious illness and disability on people who need care and not on the friends and family who often provide it. I propose a more complete view of long-term care risk that acknowledges how illness and disability reverberates through communities, posing insecurity for people beyond those in ...