Pace Law Library Blog

Medicare Provider Charge Data provided by the Centers for Medicare and Madicaid Services provide hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments for the top 100 most frequently billed discharges, paid under Medicare based on a rate per discharge using the Medicare Severity Diagnosis Related Group (MS-DRG) for Fiscal Year (FY) 2011. These DRGs represent almost 7 million discharges or 60 percent of total Medicare IPPS discharges.

Hospitals determine what they will charge for items and services provided to patients and these charges are the amount the hospital bills for an item or service. The Total Payment amount includes the MS-DRG amount, bill total per diem, beneficiary primary payer claim payment amount, beneficiary Part A coinsurance amount, beneficiary deductible amount, beneficiary blood deducible amount and DRG outlier amount.

For these DRGs, average charges and average Medicare payments are calculated at the individual hospital level. Users will be able to make comparisons between the amount charged by individual hospitals within local markets, and nationwide, for services that might be furnished in connection with a particular inpatient stay.

Tags: Health Care, medicaid, medicare

This study, The changing national role in health system governance. A case-based study of 11 European countries and Australia, is from European Observatory on Health Systems and Policies and studies 12 countries providing an overview of recent changes in national governments’ role in the governance of health systems, focusing on efforts to reconfigure responsibilities for health policy, regulation and management; the resultant policy priorities; and the initial impact.

The shift in responsibilities shows little uniform direction: a number of countries have centralized certain areas of decision-making or regulation but decentralized others. The study reviews common trends, based on the country cases, and assesses potential future developments.

Tags: European Observatory on Health Systems and Policies, Health Care, health policy

The U.S. Department of Justice has recently issued a revised edition of the National Protocol for Sexual Assault Medical Forensic Examinations. In the nine years since the protocol was initially released, there have been marked improvements in the “state of the art” for forensic medical examinations. The revised edition maintains the same standardization, quality, and best practice as the first SAFE Protocol. The revised edition has been updated with improvements to reflect current technology and practice.

“The revised SAFE Protocol reflects the many important improvements that can help increase the quality of the services victims receive. There is information on populations with special needs, such as victims with limited English proficiency, victims with disabilities, American Indian and Alaska Native victims, victims in the Military, and lesbian, gay, bisexual, and transgender victims. The new version also provides more information on topics such as drug and alcohol facilitated sexual assault, pregnancy, confidentiality, and alternative reporting procedures. The revised version also increases the emphasis on victim-centered care and collaboration, including offering victims an informed choice about participating in the criminal justice system.”

Tags: criminal law, Rape, scientific evidence

Bioethics

Is this cell a human being? : exploring the status of embryos, stem cells and human-animal hybrids / Antoine Suarez, Joachim Huarte, editors

Euthanasia

Debating euthanasia / Emily Jackson and John Keown

Food

Food, economics, and health / Alok Bhargava

Human Rights

The human right to equal access to health care / Maite San Giorgi

Patents

Patenting medical and genetic diagnostic methods / E.D. Ventose

Public Health

Tales of shit : community-led total sanitation in Africa / [guest editors: Petra Bongartz ... [et al.]]

Research Ethics

Planning ethically responsible research / Joan E. Sieber, Martin B. Tolich

Traditional Medicine

Patents as protection of traditional medical knowledge? : a law and economics analysis / Petra Ebermann

Tags: New Acquisitions

A study by the Society of Actuaries found an overall increase in health care costs but that the increseas or in some cases decreases will vary widely by state.  The study is found here.

Tags: health costs, health insurance, Patient Protection and Affordable Care Act

From the summary: “Over the past 10 years, 278 new drugs have been approved by the Food and Drug Administration, according to data from the InnoThink Center for Research in Biomedical Innovation.  One hundred-and-seventy-five of them, or 63% of those approvals, came from 41 companies that had at least two new drugs approved during that time period.”  Here is the article with links to the underlying data.

Tags: pharmaceuticals

Food

Food regulation : law, science, policy, and practice / Neal D. Fortin

Managing food safety and hygiene : governance and regulation as risk management / Bridget M. Hutter, with research assistance from Clive Jones

Salt, sugar, fat : how the food giants hooked us / Michael Moss

Occupational Safety

Occupational safety and health law handbook / authors, Melissa A. Bailey … [et. al.]

Public Health

Drinking water : a history / James Salzman

Rome, pollution, and propriety : dirt, disease, and hygiene in the eternal city from antiquity to modernity / edited by Mark Bradley with Kenneth Stow

Tags: New Acquisitions

Affordable Care Act

Leonard, Elizabeth Weeks, Susan Scholz and Raquel Meyer Alexander.  Employers united: an empirical analysis of corporate political speech in the wake of the Affordable Care Act.  38 J. Corp. L. 217-257 (2013).

Shapiro, Ilya.  Like Eastwood talking to a chair: the good, the bad, and the ugly of the Obamacare ruling.  17 Tex. Rev. L. & Pol. 1-23 (2012).

Vukadin, Katherine T.  Hope or hype?: why the Affordable Care Act’s new external review rules for denied ERISA healthcare claims need more reform.  60 Buff. L. Rev. 1201-1253 (2012).

Conscience Rights

Bowman, Matthew S. and student Christopher P. Schandevel.  The harmony between professional conscience rights and patients’ right of access.  6 Phoenix L. Rev. 31-62 (2012).

Disabilities

Wagstaff, Brandy L.  Make way for Segways: mobility disabilities, Segways, and public accommodations.  20 Geo. Mason L. Rev. 347-359 (2013).

Economics

Johnston, Carl A. and Curtis D. Rooney.  GPOs and the health care supply chain: market-based solutions and real-world recommendations to reduce pricing secrecy and benefit health care providers.  29 J. Contemp. Health L. & Pol’y 72-88 (2012).

Elder Law

Jeremiah, Onyinyechi.  Note. A thin line between inpatient and outpatient: observation status and its impact on the elderly.  20 Geo. J. on Poverty L. & Pol’y 141-159 (2012).

Employment Discrimination

Waters, Jessica L.  Testing Hosanna-Tabor: the implications for pregnancy discrimination claims and employees’ reproductive rights.  9 Stan. J. C.R. & C.L. 47-78 (3013).

Euthanasia

Lewis, Browne C.  A graceful exit: redefining terminal to expand the availability of physician-facilitated suicide.  91 Or. L. Rev. 457-493 (2012).

Evidence

Helland, Eric and Jonathan Klick.  Does anyone get stopped at the gate?  an empirical assessment of the Daubert trilogy in the states.  20 Sup. Ct. Econ. Rev. 1-33 (2012).

Price, Meredith M.  Comment. The proper application of Daubert to expert testimony in class certification.  16 Lewis & Clark L. Rev. 1349-1379 (2012).

Genetics

Boyd, William.  Genealogies at risk: searching for safety, 1930s-1970s.  39 Ecology L.Q. 895-987 (2012).

Guardianship

Johns, A. Frank.  Person-centered planning in guardianship: a little hope for the future.  2012 Utah L. Rev. 1541-1573.

Symposium. Third National Guardianship Summit: Standards of Excellence. Preface by Leslie P. Francis, introduction by Sally Hurme and Erica Wood; articles by Karen E. Boxx, Terry W. Hammond, Robert B. Fleming, Rebecca C. Morgan, Kim Dayton, Naomi Karp, Erica Wood, Linda S. Whitton, Lawrence A. Frolik, A. Frank Johns, Catherine Seal, Spencer Crona, Mary Joy Quinn, Howard S. Krooks, Julia R. Nack, Carolyn L. Dessin and Thomas Swift.  2012 Utah L. Rev. 1155-1690.

Health Care Providers

Hill, Elizabeth.  Recent development. Senate Bill 33 grants protection to emergency room providers…and just about everyone else, too.  91 N.C. L. Rev. 720-744 (2013).

Informed Consent

Gaylord, Scott W. and Thomas J. Molony.  Casey and a woman’s right to know: ultrasounds, informed consent, and the First Amendment,  45 Conn. L. Rev. 595-652 (2012).

Medicaid

Casey, Meghan C.  Note. In whose hands are we placing children’s health?: an examination of “medical necessity” for Medicaid’s EPSDT provision.  29 J. Contemp. Health L. & Pol’y 89-116 (2012).

Medical Ethics

Dayton, Kim.  Standards for health care decision-making: legal and practical considerations.  2012 Utah L. Rev. 1329-1444.

Minors

Mulder-Westrate, Kelli M.  Note. Waiting for the justice league: motivating child welfare agencies to save children.  88 Notre Dame L. Rev. 523-555 (2012).

Norton, Ashley A.  Note. The captive mind: antipsychotics as chemical restraint in juvenile detention.  29 J. Contemp. Health L. & Pol’y 152-182 (2012).

Organ Donations

Robertson, John A.  Paid organ donations and the constitutionality of the National Organ Transplant Act.  40 Hastings Const. L.Q. 221-275 (2013).

Patents

Byrnes, Chris R.  Note. Patenting life: TRIPS Article 27 & Bolivia’s proposal to ban the patenting of all life forms.  24 Geo. Int’l Envtl. L. Rev. 245-265 (2012).

Tang, Wanli (Lily).  Note. Revitalizing the patent system to incentivize pharmaceutical innovation: the potential of claims with means-plus-function clauses.  62 Duke L.J. 1069-1108 (2013).

Patient Privacy

Kimel, Catherine W.  Note. DNA profiles, computer searches, and the Fourth Amendment.  62 Duke L.J. 933-973 (2013).

Pharmaceuticals

Drugs & Money. Foreword by Jesse A. Goldner; articles by Robert I. Field, Jeremy Sugarman, M.D., Kathleen M. Boozang and Marc A. Rodwin.  6 St. Louis U. J. Health L. & Pol’y 1-165 (2012).

Kanter, Jason and Robin Feldman.  Understanding and incentivizing biosimilars.  64 Hastings L.J. 57-81 (2012).

Liu, Chenglin.  Leaving the FDA behind: pharmaceutical outsourcing and drug safety.  48 Tex. Int’l L.J. 1-32 (2012).

Okada, Seiko F.  Recent development. In re K-Dur Antitrust Litigation: pharmaceutical reverse payment settlements go beyond the “scope of the patent.”  (In re K-Dur Antitrust Litigation, 686 F.3d 197, 2012.)  14 N.C. J.L. & Tech. 303-340 (2012).

Steele, Danielle L.  Comment. The “duty of sameness” as a shield—generic drug manufacturers’ tort liability and the need for label independence after …  (PLIVA, Inc. v. Mensing, 131 S. Ct. 2567, 2011.)  43 Seton Hall L. Rev. 441-490 (2013).

Public Health

Onzivu, William.  The long road to integrating public health into sustainable development of shared freshwaters in international environmental law: lessons from Lake Victoria in East Africa.  46 Int’l Law. 867-892 (2012).

Religion

Nirenberg, Sarah.  Note. The resurgence of secularism: hostility towards religion in the United States and France.  5 Wash. U. Jur. Rev. 131-161 (2012).

Weil, Michael J.  Note. The friendly separation of church and state and bans on male circumcision.  45 Conn. L. Rev. 695-742 (2012).

Research Ethics

Mullins-Owens, Heather L., Macey L. Henderson and Jason Henderson.  Protecting a vulnerable population with little regulatory framework: a comparative analysis of international guidelines for pediatric research ethics.  29 J. Contemp. Health L. & Pol’y 36-71 (2012).

Treadaway, Lauren.  Note. Big pharma’s heart of darkness: the Alien Tort Statute and preventing clinical trial colonialism.  43 Geo. J. Int’l L. 1419-1456 (2012).

Toxicology

Myers, Donald B. Jr. and Paul A. Locke.  Modernizing U.S. chemicals laws: how the application of twenty-first century toxicology can help drive legal reform.  20 N.Y.U. Envtl. L.J. 35-98 (2012).

WIC

Cucurullo, Regina T.  The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP): comparing policies and suggesting changes.  8 J. Food L. & Pol’y 257-279 (2012).

Workers’ Compensation

Bent, Jason R.  An incentive-based approach to regulating workplace chemicals.  73 Ohio St. L.J. 1389-1455 (2012).

Brown, Matthew K.  Note. How exclusive is the workers’ compensation exclusive remedy? 2010 amendments to Oklahoma Workers’ Compensation Statute shoot down …  (Parret v. UNICCO Serv. Co., 127 P.3d 572, 2005, superseded by statute, 2010 Okla. Sess. Laws 2032-33.)  65 Okla. L. Rev. 75-131 (2012).

Wagner, Gerhard.  Tort, social security, and no-fault schemes: lessons from real-world experiments.  23 Duke J. Comp. & Int’l L. 1-61 (2012).

Tags: law review articles

The Gosnell Grand Jury Report underlies the prosecution of Gosnell and others in the intentional death of living babies born after a botched abortion and the death of one of his patients.  From the Report: “This case is about a doctor who killed babies and endangered women. What we mean is that he regularly and illegally delivered live, viable, babies in the third trimester of pregnancy – and then murdered these newborns by severing their spinal cords with scissors. The medical practice by which he carried out this business was a filthy fraud in which he overdosed his patients with dangerous drugs, spread venereal disease among them with infected instruments, perforated their wombs and bowels – and, on at least two occasions, caused their deaths. Over the years, many people came to know that something was going on here. But no one put a stop to it.”

Tags: abortion, criminal trials, Medical malpractice, reproductive rights, women's health

Place: Concierge Conference Center
780 Third Avenue (at 48th Street)
New York, NY 10017
(212) 735-0072

In January 2013, the long-awaited HIPAA Omnibus Rule was published, bringing sweeping changes to the HIPAA Privacy, Security, Enforcement, and Breach Notification rules.  Covered entities and business associates, who will have direct liability under HIPAA, ensure that their organizations comply with the new rules before the September 23, 2013 deadline.

Topics to be Discussed

• Modifications to the HIPAA Privacy and Security Rule
• Updated breach notification analysis and requirements
• Enforcement changes and penalties for non-compliance
• Business associate responsibilities and agreements
• Best practices for compliance
• Overlapping and continually evolving New York state privacy and security laws that must be evaluated along with HIPAA

8:30 a.m. – 9:00 a.m.              Registration

9:00 a.m. – 9:10 a.m.              Welcome and Introduction

9:10 a.m. – 10:00 a.m.            Changes to the Privacy, Security and Breach Notification Rules and Best Practices for Compliance

10:00 a.m. – 10:25 a.m.         Overlap with New York State Privacy and Security Laws

10:25 a.m.                                 Adjournment

• MCLE Credits: 1.5 hrs. in Areas of Professional Practice

Tags: CLE credit, HIPAA, Patient Privacy