Sale!

The Law of American Health Care 3rd Edition by Nicole Huberfeld, Elizabeth Weeks Leonard, Kevin Outterson, Matthew Lawrence 1543857388 9781543857382

Name: The Law of American Health Care 3rd Edition by Nicole Huberfeld, Elizabeth Weeks Leonard, Kevin Outterson, Matthew Lawrence 1543857388 9781543857382
SKU: EB-50997692
Availability: InStock

Original price was: $50.00.Current price is: $25.00.

The Law of American Health Care 3rd Edition Nicole Huberfeld Digital Instant Download

Author(s): Nicole Huberfeld, Elizabeth Weeks Leonard, Kevin Outterson, Matthew Lawrence

ISBN(s): 9781543847673, 9781543847666, 1543847676, 1543847668

Edition: 3

File Details: EPUB, 13.44 MB

Year: 2023

Language: English

SKU: EB-50997692 Category: Jurisprudence & Law - Medical Law Tags: Elizabeth Weeks Leonard, Kevin Outterson, Matthew Lawrence, Nicole Huberfeld

Description

The Law of American Health Care 3rd Edition by Nicole Huberfeld, Elizabeth Weeks Leonard, Kevin Outterson, Matthew Lawrence – Ebook PDF Instant Download/Delivery: 1543857388, 9781543857382
Full download The Law of American Health Care 3rd Edition after payment

Product details:

ISBN 10: 1543857388
ISBN 13: 9781543857382
Author: Nicole Huberfeld; Elizabeth Weeks Leonard; Kevin Outterson; Matthew Lawrence

With this courseware purchase, you will receive access to the Connected eBook on CasebookConnect, including: lifetime access to the online ebook with highlight, annotation, and search capabilities, plus an outline tool and other helpful resources. Connected eBooks provide what you need most to be successful in your law school classes. A student-friendly casebook for the new generation of health lawyers in an evolving legal landscape, The Law of American Health Care emphasizes lightly, carefully edited primary source excerpts, plain-language exposition, focused comprehension questions, and problems for concept application. It introduces key themes and uses them as a conceptual anchor so when the law inevitably changes, students have tools to nimbly move forward. These themes include: federalism; individual rights; fiduciary relationships; the administrative state; markets and regulation; and equity and distribution. The book engages topics in-depth, to give students a comprehensive understanding of the most important features of health care law and hands-on experience working through cutting-edge issues. New to the 3rd Edition: Current debates about government power among public health officials, legislatures, judges, and other state actors, including issues arising from the COVID-19 pandemic Public insurance materials reorganized so students can better absorb Medicare/Medicaid and apply lessons of the pandemic and litigation over various issues Solidification of ACA reforms, including surprise billing legislation and changes in the exchange subsidies that attempted to fill the Medicaid coverage gap Consolidated health care business organization materials New/revised materials and new cases in tax exempt entities and health care fraud/abuse, state action doctrine, and discrimination in healthcare/health insurance (including history of attempts to address health care discrimination, 1964 Civil Rights Act Title VI, ADA, HIPAA portability, ACA guaranteed issue, renewal, community rating, and Section 1557) Government enforcement’s more aggressive approach to labor issues Dobbs v. Jackson Women’s Health and ensuing state law chaos and federal/state conflicts Increased use of digital health care tools and telehealth driven by the pandemic Right-to-try movement and other features of biomedical research that became more relevant during the pandemic Benefits for instructors and students: Practice-oriented approach immerses students in primary source materials that include judicial opinions as well as statutory, regulatory, advisory, and empirical sources used in practice Focused on needs of students practicing health care law in a post-ACA, pandemic-impacted world First health care law casebook to reorient federal law as central authority for health care regulation (as opposed to state or common law) Exploration of two major public insurance programs provided before discussion of private insurance options, intentionally suggesting the increasing primacy of social insurance in the U.S. and underscoring even the most uniform coverage (Medicare) is complex Intro chapter with critical organizing themes and in-depth case studies which are woven throughout other chapters, including more prominent emphasis on equity and distributive justice Text boxes highlight key lessons and help explain/enhance material Directed Questions, hypothetical Problems, and end-of-chapter Capstone Problems support focused reading and clearer synthesis of major issues Manageable length Focused on topics encountered in the day-to-day practice of health law Essential connective narrative without overwhelming notes New co-author with deep health care legislative and regulatory experience

The Law of American Health Care 3rd Table of contents:

Chapter 1 Introduction to American Health Care Law

A. Introduction

B. Common Themes in Health Care Law

1. Individual Rights and Governmental Powers

Jacobson v. Commonwealth of Massachusetts, 197 U.S. 11 (1905)

2. Health Care Relationships and Fiduciary Duties

Tenet Physicians Settle Case over Unnecessary Heart Procedures at

Redding Medical Center, USA, Med. News Today, Nov. 17, 2005

Campbell v. Redding Medical Center, 421 F.3d 817 (9th Cir. 2005)

Jon R. Gabel et al., Where Do I Send Thee? Does Physician- Ownership Affect Referral Patterns to Ambulatory Surgery Centers?, 27 Health Aff. 165 (2008)

3. The Health Care Administrative State Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination, 86 Fed. Reg. 61555 (Nov. 5, 2021)

Biden v. Missouri, Becerra v. Louisiana, 142 S. Ct. 647 (January 13, 2022)

4. Markets and Their Limits

Kenneth J. Arrow, Uncertainty and the Welfare Economics of Medical Care, 53 Am. Econ. Rev. 941 (1963)

5. Equity and Distribution

Dayna Bowen Matthew, Health Care, Title VI, and Racism’s New Normal, Geo. J.L. & Mod. Critical Race Persp. 3 (2014)

PART I HEALTH INSURANCE

Chapter 2 Public Provision of Health Insurance – Medicare

A. Introduction to Medicare

B. History

Prohibition against any Federal interference, 42 U.S.C. §1395

Option to individuals to obtain other health insurance protection, 42 U.S.C. §1395b

C. Eligibility

D. Delivery of Care and Benefits

1. Part A

Scope of benefits, 42 U.S.C. §1395d

Definitions, 42 U.S.C. §1395x

2. Part B

Establishment of supplementary medical insurance program for the aged and the disabled, 42 U.S.C. §1395j

3. Part C

Eligibility, election, and enrollment, 42 U.S.C. §1395w-21

4. Part D

Fox Insurance Co. v. Centers for Medicare and Medicaid Services, 715 F.3d 1211 (9th Cir. 2015)

E. Payment: Fee for Service, Prospective Payment Systems, and Alternatives

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Changes and FY2011 Rates, 275 Fed. Reg. 50,042 (Aug. 16, 2010)

Adirondack Med. Ctr. v. Sebelius, 740 F.3d 692 (D.C. Cir. 2014)

F. The Power of Government Reimbursement to Change Provider Behavior

Emergency Medical Treatment and Labor Act, 42 U.S.C. §1395dd

Yunwei Gai & Dessislava Pachamanova, Impact of the Medicare hospital readmissions reduction program on vulnerable populations, 19 BMC Health Servs. Res. 837 (2019)

G. Medicare Appeals Processes

In the Case of the Estate of W.D., Department of Health & Human Servs. Departmental Appeals Bd., Decision of Medicare

Appeals Council (2009)

Shalala v. Illinois Council on Long Term Care, Inc., 529 U.S. 1 (2000)

Chapter 3 Public Provision of Health Insurance – Medicaid

A. Introduction

B. Legislative History

C. Eligibility

State plans for medical assistance, 42 U.S.C. §1396a (a) (10) (A)

Annual Update of the HHS Poverty Guidelines, 87 Fed. Reg. 3315 (Jan. 21, 2022)

National Federation of Independent Business v. Sebelius, 567 U.S. 519 (2012)

Stewart v. Azar, 313 F. Supp. 3d 237 (D.D.C. 2018)

D. Delivery of Care and Benefits State plans for medical assistance, 42 U.S.C. § 1396a Sufficiency of amount, duration, and scope, 42 C.F.R. §440.230

S.D. ex rel. Dickson v. Hood, 391 F.3d 581 (5th Cir. 2004)

Purpose; State child health plans, 42 U.S.C. §1397aa

E. Structure

Appropriations, 42 U.S.C. §1396-1

Definitions, 42 U.S.C. §1396d

1. State Plans for Participating in Medicaid

Payment to States, 42 U.S.C. §1396b

Definitions, 42 U.S.C. §1396d(b)

Operation of State plans, 42 U.S.C. §1396c

2. Waivers and Medicaid Managed Care Demonstration projects, 42 U.S.C. §1315 (SSA §1115) Medicaid and Children’s Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability, 80 Fed. Reg. 31,097 (June 1, 2015)

Chapter 4 Regulation of Private Health Insurance

A. Introduction

1. Cost Sharing in Private Health Insurance

2. Duty to Provide Health Care

3. Market for Privately Purchased Health Insurance

B. Expanding Coverage Through the Private Market

1. Insurance Risk Pooling

Blue Cross & Blue Shield United of Wisconsin v. Marshfield Clinic, 65 F.3d 1406 (7th Cir. 1995)

2. State Regulation of Managed Care

Lubeznik v. Health Chicago, Inc., 644 N.E.2d 777 (III. App. Ct. 1994)

Emergency services requirements; restrictive formulary requirements, Ga. Code Ann. §33-20A-9

Regulation by State law; Federal law relating specifically to

3. Federal Health Insurance Regulation

Preventing surprise medical bills, 42 U.S.C. §300gg-111

Requirement to maintain minimum essential coverage, 26 U.S.C. §5000A

C. Employer-Sponsored Health Insurance

1. Employer Shared Responsibility

Shared Responsibility for Employers Regarding Health Coverage, 79 Fed. Reg. 8544-01 (Feb. 12, 2014)

2. ERISA Preemption

Civil enforcement, 29 U.S.C. §1132 (ERISA §502)

Other laws, 29 U.S.C. §1144 ERISA §514)

Aetna Health Inc. v. Davila, 542 U.S. 200 (2004)

Rush Prudential HMO, Inc. v. Moran, 536 U.S. 355 (2002)

Kentucky Association of Health Plans v. Miller, 538 U.S. 329 (2003)

Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (1989)

3. Substantive Federal Regulation of Employer-Sponsored Health Plans

D. Individual and Small-Group Markets

1. Coverage Through the Exchanges

King v. Burwell, 135 S. Ct. 2480 (2015)

2. Government Subsidies for Private Health Insurance Purchase

Refundable credit for coverage under a qualified health plan, 26 U.S.C. §36B

3. Essential Health Benefits

Essential health benefits requirements, 42 U.S.C. §18022

Coverage of preventive health services, 42 U.S.C. §300gg-13

4. State Innovation Waivers

Basis and purpose, 31 C.F.R. §33.100

Coordinated waiver process, 31 C.F.R. §33.102

Waivers for State Innovation, 80 Fed. Reg. 78,131 (Dec. 16, 2015)

PART II

THE BUSINESS OF HEALTH CARE

3. Federal Health Insurance Regulation

Preventing surprise medical bills, 42 U.S.C. §300gg-111

Requirement to maintain minimum essential coverage, 26 U.S.C. §5000A

C. Employer-Sponsored Health Insurance

1. Employer Shared Responsibility

Shared Responsibility for Employers Regarding Health Coverage, 79 Fed. Reg. 8544-01 (Feb. 12, 2014)

2. ERISA Preemption

Civil enforcement, 29 U.S.C. §1132 (ERISA §502)

Other laws, 29 U.S.C. §1144 ERISA §514)

Aetna Health Inc. v. Davila, 542 U.S. 200 (2004)

Rush Prudential HMO, Inc. v. Moran, 536 U.S. 355 (2002)

Kentucky Association of Health Plans v. Miller, 538 U.S. 329 (2003)

Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (1989)

3. Substantive Federal Regulation of Employer-Sponsored Health Plans

D. Individual and Small-Group Markets

1. Coverage Through the Exchanges

King v. Burwell, 135 S. Ct. 2480 (2015)

2. Government Subsidies for Private Health Insurance Purchase

Refundable credit for coverage under a qualified health plan, 26 U.S.C. §36B

3. Essential Health Benefits

Essential health benefits requirements, 42 U.S.C. §18022

Coverage of preventive health services, 42 U.S.C. §300gg-13

4. State Innovation Waivers

Basis and purpose, 31 C.F.R. §33.100

Coordinated waiver process, 31 C.F.R. §33.102

Waivers for State Innovation, 80 Fed. Reg. 78,131 (Dec. 16, 2015)

PART II

THE BUSINESS OF HEALTH CARE

Chapter 5

Structure and Governance of Health Care Entities

A. The Professional Workforce

1. Professional Licensure

Virginia Board of Medicine, Regulations Governing the Practice of Medicine, Osteopathy, Podiatry and Chiropractic

Certain data required, Va. Code §54.1-2910.1

Structure and Governance of Health Care Entities

A. The Professional Workforce

1. Professional Licensure

Virginia Board of Medicine, Regulations Governing the Practice of Medicine, Osteopathy, Podiatry and Chiropractic

Certain data required, Va. Code §54.1-2910.1

3. Federal Health Insurance Regulation

Preventing surprise medical bills, 42 U.S.C. §300gg-111

Requirement to maintain minimum essential coverage, 26 U.S.C. §5000A

C. Employer-Sponsored Health Insurance

1. Employer Shared Responsibility

Shared Responsibility for Employers Regarding Health Coverage, 79 Fed. Reg. 8544-01 (Feb. 12, 2014)

2. ERISA Preemption

Civil enforcement, 29 U.S.C. §1132 (ERISA §502)

Other laws, 29 U.S.C. §1144 ERISA §514)

Aetna Health Inc. v. Davila, 542 U.S. 200 (2004)

Rush Prudential HMO, Inc. v. Moran, 536 U.S. 355 (2002)

Kentucky Association of Health Plans v. Miller, 538 U.S. 329 (2003)

Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (1989)

3. Substantive Federal Regulation of Employer-Sponsored Health Plans

D. Individual and Small-Group Markets

1. Coverage Through the Exchanges

King v. Burwell, 135 S. Ct. 2480 (2015)

2. Government Subsidies for Private Health Insurance Purchase

Refundable credit for coverage under a qualified health plan, 26 U.S.C. §36B

3. Essential Health Benefits

Essential health benefits requirements, 42 U.S.C. §18022

Coverage of preventive health services, 42 U.S.C. §300gg-13

4. State Innovation Waivers

Basis and purpose, 31 C.F.R. §33.100

Coordinated waiver process, 31 C.F.R. §33.102

Waivers for State Innovation, 80 Fed. Reg. 78,131 (Dec. 16, 2015)

PART II

THE BUSINESS OF HEALTH CARE

Chapter 5

Structure and Governance of Health Care Entities

A. The Professional Workforce

1. Professional Licensure

Virginia Board of Medicine, Regulations Governing the Practice of Medicine, Osteopathy, Podiatry and Chiropractic

Certain data required, Va. Code §54.1-2910.1

Chapter 6

Tax-Exempt Health Care Charitable Organizations

A. Introduction

B. Health Care as a Charitable Purpose Exemption from tax on corporations, certain trusts, etc., 26 U.S.C. §501 Revenue Ruling 69-545, 1969-2 С.В. 117

C. Federal Requirements for Tax-Exempt Hospitals

Chapter 7 Health Care Fraud and Abuse

A. Introduction

DOJ Press Release, Criminal Charges Brought Against Owners and Executives of Medical Businesses, Physicians, Marketers, and Manufacturers of Fake COVID-19 Vaccination Record Cards with Losses Exceeding $149 Million (April 20, 2022)

Remarks by Deputy Assistant Attorney General for the Civil Division Ethan P. Davis at the U.S. Chamber of Commerce Law Reform Conference (June 26, 2020)

Chapter 8 Competition in Health Care Markets

A. Introduction

B. Health Care Market Imperfections

C. Introduction to Antitrust Law

Trusts, etc., in restraint of trade illegal; penalty, 15 U.S.C. §1 (Sherman Act section 1)

Monopolizing trade a felony; penalty, 15 U.S.C. §2 (Sherman Act section 2)

Acquisition by one corporation of stock of another, 15 U.S.C. §18 (Clayton Act section 7)

Unfair methods of competition unlawful; prevention by Commission, 15 U.S.C. §45(a) (FTC Act section 5)

PART III PATIENT PROTECTIONS

Chapter 9 Discrimination in Health Care and Health Insurance

A. Introduction

Jessica Roberts and Elizabeth Weeks, Healthism (2017)

B. Federal Nondiscrimination Statutes

1. Title VI

Discrimination prohibited, 42 C.F.R. §80.3

Dayna Bowen Matthew, Health Care, Title VI, and Racism’s New Normal, 6 Geo. J. L. & Mod. Critical Race Persp. 3 (2014)

2. Americans with Disabilities Act

Prohibition of discrimination by public accommodations, 42 U.S.C. §12182.

People also search for The Law of American Health Care 3rd :

american healthcare act of 2017 explained

american health care act summary

what is the american health care act

how does america’s healthcare system work