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Health Law Blog

Commentary on anything-- if not quite everything-- happening in the health law field, with emphasis on federal developments but including state developments (especially Texas) plus occasional digressions into family law, administrative law, constitutional law, poetry, and other things that matter.

Post Frequency: 1.4/day

Last Entry: September 27, 2009 at 23:17:17

Dallas Morning News' excellent series on health care costs (and other things that matter)

Posted on September 27, 2009
Hooray to the Dallas Morning News for its week-long series on health care and the systemic issues that have contributed to the crisis we are now in. Free registration may be required to view all of these articles. . . .Sun., 9/27: High prices, red tape fuel popular Dallas doctor's move to Temple Sun...

Good article in today's NY Times

Posted on March 29, 2009
Good article in today's NY Times comparing the Obama health reform plan to the Massachusetts experience, including a nifty graphic that summarizes the similarities and differences nicely.I think Obama's initial emphasis on cost-control is smart - it's by no means clear that the U...

Dallas Morning News: series on palliative care

Posted on December 18, 2008
This is quite a remarkable series of articles on end-of-life care and in particular palliative care at Baylor University Medical Center. Short of watching the amazing 6-hour documentary by Frederick Wiseman ("Near Death"), this is as close as most of us will get to the true in-hospital experience until it happens to one of us or someone we love...

WSJ backs incentives for organ donation

Posted on December 17, 2008
I know it will not come as a surprise that the house organ for American capitalism thinks a market for buying and selling human organs would produce a better system than the one we have now (100,000 patients on waiting lists, four times as many as were on lists when the current system was enacted into law in 1984), but maybe -- this time, at least -- they're right...

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WSJ (gasp

Posted on December 17, 2008

Vatican issues 3rd major bioethics pronouncement in 21 years

Posted on December 12, 2008
First, it was Donum Vitae (The Gift of Life) in 1987, followed by Evangelium Vitae (The Gospel of Life) in 1995. Now the Vatican has given us its third major pronouncement on bioethics in over 2 decades with Dignitas Personae (The Dignity of the Person), released today...

Mission vs. Money: WSJ profiles Mt. Sinai Hospital in Chicago

Posted on December 12, 2008
Interesting multi-media report in today's on-line WSJ ("Pursuing Charitable Mission Leaves a Hospital Struggling" (may require subscription)) about the financial pressures on nonprofit Mt. Sinai. Here's the video:

Cleveland Clinic addresses financial conflicts of interest head-on

Posted on December 03, 2008
Today's Times has an interesting piece on the Cleveland Clinic's new policy of publicly reporting the business relationships that any of its 1,800 staff doctors and scientists have with drug and device makers. The clinic, one of the nation?s most prominent medical research centers, is making a complete disclosure of doctors? and researchers? financial ties available on its Web site, http://

13-year-old refuses heart transplant

Posted on November 26, 2008
The story of Hannah Jones is provoking some strong reactions -- both positive and negative -- in the U.K. The 13-year-old girl has refused a heart transplant without which her doctors say she has only months to live. Hannah's reasoning: potentially lousy quality of life and the possibility that the anti-rejection medicine will trigger a relapse of the leukemia she's been treated for since she was

Larry Gostin's "Public Health Law" text in new edition

Posted on November 23, 2008
The great just got better. No public-health law library would be complete without Larry Gostin's Public Health Law -- Power, Duty, Restraint. Originally published eight years ago, PHL was always more than simply a good place to start your research: Gostin's opus had depth to match its breadth...

Health insurers agree to drop pre-existing condition exclusion

Posted on November 20, 2008
You read that right. According to an article in today's New York Times, the two big health-insurance industry associations have agreed to enroll all applicants, regardless of pre-existing condition. The catch? They will only do so if Congress requires all citizens to have health insurance...

Washington passes PAS ballot measure

Posted on November 09, 2008
The State of Washington became the second state in the U.S. to legalize physician-assisted suicide. Initiative 1000 passed 58-42, according to the Seattle Post-Intellgencer. The measure looks virtually identical to the Oregon Death With Dignity Act, which was enacted in 1997...

Interesting report from The Commonwealth

Posted on November 03, 2008
Interesting report from The Commonwealth Fund: More than two-thirds of respondents to the latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey believe the way we pay for health care in the United States must be fundamentally reformed...

Tax-exempt hospitals and "community benefit"

Posted on October 20, 2008
Excellent discusion by John Colombo over at Nonprofit Law Prof Blog, ostensibly about the recent GAO report, Nonprofit Hospitals: Variation in Standards and Guidance Limits Comparison of How Hospitals Meet Community Benefit Requirements (GAO 08-880), but also about current thinking as to whether nonprofit hospitals should be tax-exempt in the first place...

Seton Hall Law Review Symposium

Posted on October 15, 2008
Preparing for a Pharmaceutical Response to Pandemic Influenza: A Seton Hall Law Review Symposium October 23-24, 2008 Seton Hall University School of Law Newark, NJ Co-Sponsored by The Center for Health & Pharmaceutical Law and the Gibbons Institute of Law, Science & Technology at Seton Hall University School of Law Newark, New Jersey Seton Hall Law School?s Center for Health and

Pay for the best care, save money

Posted on September 27, 2008
Cary Grant is supposed to have said it's cheaper in the long run to buy the best shoes possible -- they will hold up better, last longer, look better over time than the supposedly less expensive alternative. It turns out that health care may work the same way...

Insurer to pay $225M settlement in Medicaid coverage-denial suit

Posted on August 18, 2008
The Kaiser Network has picked up on a report from Reuters that Amerigroup has settled a qui tam whistleblower suit in which it was accused of denying coverage to Medicaid beneficiaries who were pregnant or had health problems. (Under the law, Amerigroup was obligated to provide coverage for a Medicaid enrollees...

Pediatric DCD in the news

Posted on August 14, 2008
Today The Washington Post has an article -- Infant Transplant Procedure Ignites Debate -- that builds on yesterday's AP article about three cases in which infant hearts were harvested under a "donation after cardiac death" ("DCD") protocol, which all transplant centers are required by UNOS and HHS...

"For better or worse, for richer or poorer, in sickness and in health . . . "

Posted on August 13, 2008
How to pick a life partner, 2008-style: "Let's see. . . . Good personality? Check. Kind to small animals and young children? Check. Reasonably communicative and okay with intimacy? Check. Excellent health care insurance? DOUBLE CHECK!!" That's the message in yesterday's New York Times article, Health Benefits Inspire Rush to Marry, or Divorce...

U.S. health care reform: can 8 out of 10 Americans be wrong?

Posted on August 07, 2008
The latest from The Commonwealth Fund is a report based upon a Harris Interactive survey that sought the opinions of a sample of 1,004 adults about our health care system. Here's a summary of the results: Overall, the telephone survey of a representative sample of 1,004 adults age 18 and older reveals that the health care delivery system does not serve the public well ? eight of 10 respondents

Congresswoman Slams Religious Right's Assault on Science's "Edgier" Side

Posted on August 06, 2008
Scientific American has an on-line interview with Colorado Rep. Diana DeGette, who recently published, "Sex, Science and Stem Cells: Inside the Right Wing Assault on Reason" (Congresswoman Slams Religious Right's Assault on Science's "Edgier" Side). Here's their intro: Six-term Democratic Congresswoman Diana DeGette owns a dubious distinction: She is one of the two co-authors of the bill that

New Study Looks at Uninsurance Among Immigrants

Posted on August 06, 2008
New Study Looks at Uninsurance Among Immigrants [from today's Kaisernetwork.org's Daily Health Policy Report] Although U.S.-born residents still make up the majority of uninsured U.S. residents, the percentage of uninsured documented and undocumented immigrants is growing, according to a study released on Tuesday by the Employee Benefit Research Institute, the Kansas City Star reports...

Latest health-related reports from GAO

Posted on August 06, 2008
Electronic Health Records: DOD and VA Have Increased Their Sharing of Health Information, but More Work Remains. GAO-08-954, July 28, 2008 (43 pages). http://www.gao.gov/docdblite/details.php?rptno=GAO-08-954 Emergency Preparedness: States Are Planning for Medical Surge, but Could Benefit from Shared Guidance for Allocating Scarce Medical Resources...

Texas Attorney General: Charitable Hospital Summit

Posted on August 06, 2008
For those interested in charity care and community benefits in Texas, the Texas Attorney General is hosting a "summit" on Tuesday, September 16, in Austin. The schedule looks pretty good, if a little basic, but it's the Attorney General's office, for crying out loud, and they do have enforcement authority for Health and Safety Code chapter 311 (though it would be nice to know whether the speakers

What it means to be uninsured in America

Posted on August 05, 2008
The New York Times has an article (Millions With Chronic Disease Get Little to No Treatment) today about the most recent Annals of Internal Medicine survey (abstract) of just exactly what health care services the uninsured with chronic conditions aren't getting...

All hospitals have to pull their weight on uncompensated care

Posted on July 27, 2008
Tim Walters filed this op-ed piece Saturday in the Cleveland Plain Dealer: All hospitals have to pull their weight on uncompensated care. Seems MetroHealth, the nationally recognized public hospital in town, is in perilous financial condition. It is the largest provider of uncompensated health care in the state of Ohio, and if it goes under, Walters wonders what will happen to indigent patients

5th Circuit's decision in Poliner is out

Posted on July 23, 2008
Total win for Presbyterian/THR/ medical-staff docs. HCQIA immunity for money damages held to apply to emergency suspension decisions during the fact-investigation phase of the peer-review process. Judge Higginbotham's opinion for a unanimous panel is here...

Trying to Save by Increasing Doctors? Fees

Posted on July 21, 2008
Trying to Save by Increasing Doctors? Fees That's the headline in this morning's New York Times' story about health plans (including Medicare) that are going to try to gin up some extra compensation for primary and preventve care in the hope that it will reduce more costly acute care down the road...

Making Malpractice a Criminal Matter

Posted on July 17, 2008
The Wall Street Journal's Law Blog has an entry today on a criminal case brought against a physician at the Harvard School of Public Health. The case is described a little more fully in the Boston Globe. According to the Globe story, the physician -- Dr...

The vaccine-autism debate: a lecture

Posted on June 15, 2008
From Mary Holland at NYU comes notice of this lecture: THE VACCINE-AUTISM DEBATE:WHY WON'T IT GO AWAY? David Kirby, AuthorEvidence of Harm - Mercury in Vaccines and the Autism Epidemic: A Medical Controversy Thursday, June 26, 20086:30 - 9:00 PM NYU School of Law 40 Washington Square South,Vanderbilt Hall, Room 204 RSVP REQUIRED: kirbylecture@gmail...

Med mal premiums in Mass., 1975-2005

Posted on May 31, 2008
Marc Rodwin, one of the most innovative and consistently interesting health law scholars around, has published (with others) in the May/June issue of Health Affairs a very useful study of med mal premiums in Massachusetts (described as "a high-risk state") over the 30-year period of 1975-2005...

American College of Physicians: E-Health Recommendations

Posted on May 31, 2008
The ACP's new report, E-Health and Its Impact on Medical Practice, is presented on their news page. The challenge of moving physicians to electronic health records is daunting. This is from the press release: Health care may be the fastest growing industry, but it has been slow to adopt the use of technology...

Two Versions of End-of-Life Care

Posted on May 31, 2008
The New York Times had an interesting article Friday (In New York City, Two Versions of End-of-Life Care) on variations in end-of-life care -- not the usual comparison of EOL expenditures between geographically disparate locations, but this time between well-off private hospitals and public facilities a couple of miles apart within the same city...

Cash Before Chemo

Posted on April 29, 2008
The Wall Street Journal ran a chilling Page One story yesterday: Cash Before Chemo: Hospitals Get Tough (link may require paid subscription). Here's a little video teaser: Once again, it's all too easy in the U.S. system to find yourself underinsured for a serious illness, and when you're underinsured, you might as well be uninsured.

PBS Frontline: "Sick Around the World"

Posted on April 13, 2008
This Tuesday, "Frontline" takes a look at the U.S. health care system by comparing what we have against other countries who manage to provide better access and produce better outcomes at a lower cost. Here are three preview clips: Here's the press release on the program: FRONTLINE presents SICK AROUND THE WORLD Tuesday, April 15, 2008, at 9 P...

Some basic health-reform lessons

Posted on April 11, 2008
Paul Krugman's excellent op-ed yesterday -- Health Care Horror Stories - New York Times -- ought to be required reading across the country. There is plenty to debate about how to fix our health care system, and he's made it clear in past columns that he favors Hillary's universal-coverage-now over Obama's phased-in plan...

More medical records abuses

Posted on April 10, 2008
It seems that UCLA Medical Center had a serial HIPAA violator on its payroll (until he or she was fired last year for checking out Britney Spears' medical record). See: More UCLA records abuses - Los Angeles Times. We knew this was wrong even before HIPAA, didn't we?

Law review call for papers: "Preparing for a phamaceutical Response to Pandemic Influenza"

Posted on March 18, 2008
Seton Hall Law Review Symposium Preparing for a Pharmaceutical Response to Pandemic Influenza Co-sponsored by the Health Law & Policy Program?s Center for Health & Pharmaceutical Law and the Gibbons Institute of Law, Science & Technology October 23-24, 2008 Seton Hall Law School Newark, NJ Call for Papers Seton Hall Law School?s Center for Health and Pharmaceutical Law and the Seton Hall

In my Law, Literature and Medicine

Posted on March 06, 2008
In my Law, Literature and Medicine class, the poem "Gaudeamus Igitur" by John Stone -- eminent cardiologist and medical educator and poet-essayist par excellence -- is always a hit (you can listen to an NPR story that includes a snippet of the poem). It was written as a graduation valedictory at the Emory University School of Medicine, and it provides a wonderful review of the medical school

Are antibiotics futile for nursing home patients with advanced dementia?

Posted on March 04, 2008
Today's New York Times has a piece about a recent article in the Archives of Internal Medicine in which the authors question the use of antibiotics to treat infections in nursing home patients with advanced dementia. The study concludes: This prospective cohort study demonstrates that antimicrobial exposure among nursing home residents with advanced dementia is extensive and steadily increases

Location, location, location.

Posted on March 03, 2008
It's the punchline to an old joke, but this time it's deadly serious. According to a recent article in Pediatrics (summary; abstract here - full text here), "Black babies with very low birth weights are nearly twice as likely as their white counterparts to be born at New York City hospitals with high risk-adjusted neonatal death rates...

Donation after cardiac death and the LA story

Posted on February 27, 2008
The papers are all over yesterday's story about the prosecution of a young surgeon in Los Angeles who is accused of hastening a patient's death (or, to be less circumspect but at least as accurate about it, of killing a patient) in order to procure organs for transplant...

Organ donation, trasnplant discussed on NPR

Posted on February 24, 2008
Weekend Edition - Sunday had a very fine segment this morning on organ donation. Given what they were trying to do with this piece, there probably wasn't time to portray the personal impact of donating and receiving, convey some of the statistics about the various waiting lists, provide a brief overview of some of the evolving strategies for increasing organ yields, AND discuss some of the

Human experimentation research request

Posted on January 03, 2008
From Jim DuBois, PhD, DSc, M�der Endowed Professor, Department Chair and Center Director, Center for Health Care Ethics & Becky Volpe, Graduate Assistant, Center for Health Care Ethics: We are studying the personality and environmental factors that contribute to major ethical breaches in the areas of medical practice and research...

Medical Futility Blog

Posted on December 16, 2007
I don't know how I missed it, but here (better late than never) is a link to Prof. Thad Pope's estimable Medical Futility Blog, which does a nice job of tracking legal developments and the on-going political and scholarly debate over what to do (if anything) about claims for "futile" treatment.

Health reform: the time for happy chatter is over

Posted on December 16, 2007
Robert Samuelson -- Newsweek columnist and Washington Post op-editorialist -- had a typically fine piece in last Thursday's Post. Here's the nub of his argument: We're told that the uninsured are our biggest health-care problem, but they aren't. Runaway health spending is...

ACP publishes advance copy of major health reform policy statement

Posted on December 04, 2007
Intending to be a major player in the 2008 debate over health reform and universal coverage, the American College of Physicians has posted an advance copy of an article that will appear in its January 1, 2008, issue of Annals of Internal Medicine: "Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries...

New York City Law Review Issues Call for Papers on Health Care

Posted on December 02, 2007
The New York City Law Review announces a call for papers for its spring symposium, "Critical Condition: What's Ailing Health Care in America?" This event will be held Friday, March 28, 2008, at the Association of the Bar of the City of New York's Meeting Hall in Midtown Manhattan...

AHLA Health Lawyers Weekly, Nov. 30

Posted on December 02, 2007
Some interesting stuff in the Health Lawyers Weekly this time around: Top StoriesOIG Takes Back Power To Investigate Employee Criminal Conduct From FDA -- The Department of Health and Human Services Office of Inspector General (OIG) will no longer share responsibility with the Food and Drug Administration (FDA) for investigating potential criminal misconduct by FDA employees, Inspector General

Informed consent & SCOTUS: A tale of two doctrines

Posted on December 02, 2007
Interesting paper . . . The Constitutional Right to Make Medical Treatment Decisions: A Tale of Two Doctrines JESSIE HILL Case Western Reserve University - School of Law Texas Law Review, Vol. 86, No. 2, December 2007 Case Legal Studies Research Paper No...

WSJ: Health policy caps mean catastrophic coverage may not be there when needed

Posted on November 30, 2007
Yesterday's WSJ ran a story that highlights the plight of the insured middle-class in this country: It's possible to max out a health policy with a $1.5 million cap in the metaphorical blink of an eye. The story is here (though it may require a paid subscription to read it).

When hospice patients don't die quickly enough, Medicare comes knocking

Posted on November 27, 2007
Some years ago, the Medicare program proposed to recoup hospice payments if a patient didn't die within 6 months, which was the probable life-expectancy that a physician had to certify for a patient to receive the Medicare hospice benefit. As I recall, that proposal was met with howls of protest and dropped...

Krugman: Health Care Excuses

Posted on November 09, 2007
Okay, I know he's a liberal (Exh. 1: "The Conscience of a Liberal"), and so am I, so there are times when I suppose Paul Krugman's arguments seem irresistible when they're not. But today's column strikes me as just plain common-sensical. Krugman offers up four common excuses often used to argue against health reform and then refutes them...

Insurer misconduct alleged in California

Posted on November 09, 2007
From today's Modern Healthcare: Calif. insurance chief probes report of cancellationsCalifornia?s insurance commissioner is investigating a report that Health Net rewarded an analyst more than $20,000 in bonuses tied to canceling individual health insurance policies, thereby saving the company millions in medical expenses...

Deputies seize baby to test blood against parents' will

Posted on October 25, 2007
Deputies seize baby to test blood against parents' will - Associated Press -- Here's a nicely framed conflict between public health laws designed to protect newborns vs. parental religious beliefs, in state (Neb.) that doesn't provide a religious exemption for newborn testing...

Iglehart on the House's failure to override Bush's SCHIP veto

Posted on October 21, 2007
John Iglehart, the founding editor of Health Affairs and national corespondent for the New England Journal of Medicine, posted his instant analysis [may require paid subscription] of the House's failure on Thursday to override the President's veto of the SCHIP reauthorization bill, HR 976...

Federeal employees' health plan not much of a model for reform

Posted on October 20, 2007
There's a good analysis of the Federal Employees Health Benefits Plan (FEHBP) by Reed Abelson in The New York Times today. Various presidential candidates are talking about the FEHBP in their stump speeches, suggesting that this country's 47 million uninsured could be covered by the same plan that covers their elected representatives...

Major-party presidential candidates on health reform

Posted on October 04, 2007
Here are links to the major-party presidential candidates' health-policy web pages, which I offer in alpha order and without editorial comment: Joe Biden: http://www.joebiden.com/issues/?id=0003Sam Brownback: http://www.brownback.com/s/Issues/tabid/60/Default...

SCHIP

Posted on October 02, 2007
Here's a news post courtesy of FDLI's SmartBrief: White House to face state SCHIP lawsuits -- New Jersey was the first of several states expected to file lawsuits against the Bush administration over rules set in August that limit state coverage of children's health insurance to exclude children in middle-income families...

FDA's oversight of human-subject research: slim to none

Posted on September 28, 2007
That's the bottom line of a report from the Inspector General of DHHS, according to an article in the New York Times. The IG's report (pdf), and a news release (pdf) about its conclusions, were released today. In his typically media-friendly way, Art Caplan colorfully summarized the report's conclusions this way: "In many ways, rats and mice get greater protection as research subjects in the

Health Lawyers Weekly, September 14

Posted on September 16, 2007
Crowell & Moring partner Art Lerner and counsel Michael Paddock have an analysis of the FTC's recent Evanston Northwestern Healthcare Corp. decision in this week's Health Lawyers Weekly from the AHLA. The decision, in which the Commission held that Evanston's acquisition of Highland Park Hospital violated Section 7 of the Clayton Act but declined to order divestiture, was a rare if not

Vatican reaffirms stance on obligatory nature of ANH

Posted on September 16, 2007
"The administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life. It is therefore obligatory to the extent to which, and for as long as, it is shown to accomplish its proper finality, which is the hydration and nourishment of the patient...

Insuring the uninsured: the right thing to do, but what's in it for me?

Posted on September 16, 2007
Today's New York Times has an article on the new round of health-care reform proposals that are being advanced by various presidential candidates. On the dim prospects for any of the proposals to extend coverage to the uninsured and improve coverage for the underinsured, the article makes the following point: In short, altruism has its limits, as does the public?s appetite for trade-offs in their

Drake Law School looking for health law/insurance law teacher

Posted on August 30, 2007
Faculty opening at Drake: DRAKE LAW SCHOOL seeks applications for a tenure-track position in the area of health law, insurance law and related fields commencing in the 2008-09 academic year. We are interested in both entry-level and experienced candidates with a J...

Medicare beneficiaries lag in taking advantage of covered screenings and preventive care

Posted on August 27, 2007
From the Wall Street Journal (via AHLA's Health Law Daily [link should be good for about a week]): CMS says Medicare is spending more on prevention efforts. The Wall Street Journal (8/26, McQueen) reported, "Medicare, the federal health-insurance program for older Americans, increasingly is paying for screening tests and immunizations that previously were not covered...

Tax-exempt hospitals and "community benefit"

Posted on August 13, 2007
This is a bit tardy but well worth noting here and reading the underlying documents as time permits. In July the IRS issued an interim report on community benefit in the hospital industry (news release), based upon responses to its 2006 questionnaire to 500 hospitals...

Health Lawyers Weekly, August 10

Posted on August 12, 2007
The AHLA's Health Lawyers Weekly features two articles by lawyers from Hall, Render, Killian, Heath & Lyman, P.S.C., on the IRS' publication in the July 26 Federal Register of its final rule for 403(b) plans (a/k/a tax-deferred annuity plans) and DOL's simultaneous publication of Field Assistance Bulletin 2007-02 containing guidance on how 403(b) plans can avoid compliance with ERISA...