Health Law
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Health Law WVU College of Law Spring 2007 Furrow, et al. Health Law: Cases, Materials and Problems(5th ed., 2004)
Introduction
1. The American health care system
2. Cost, quality & access
3. Reform options
• Consumer-Directed health care
• WV reforms
Public Health Care Systems
4. Medicare
• Eligibility & benefits
• Medicare Part D
• Medicare reimbursement
5. Medicaid
• Eligibility & benefits
• Medicaid reimbursement
• Medicaid federalism
• SCHIP
6. WV Programs:
• State Rx benefit programs
• WV Rx Council http://www.state.wv.us/got/pharmacycouncil/ • WV health care reforms
Regulation of Private Health Care Markets
7. State law:
• Introduction to insurance & managed care
• Non-statutory duty to provide care?
• Liability in contract & tort
• State regulation of insurance & managed care
8. Federal regulation of private health care markets:
• The Internal Revenue Code
• EMTALA
• Title VI
• ERISA preemptions
• HIPAA, ADA & COBRA
• False Claims I
• False Claims II & qui tam
• Fraud & Abuse
• Stark II
• Antitrust: Cartels
• Antitrust: Provider-controlled networks
Health Care Professionals
9. Professional relationships in health care:
• Staff privileges
• Payor contracts
• Labor & employment
o At-will
o NLRB
• Corporate practice of medicine
• Disclosure of financial incentives
Nonprofit health care organizations
10. Health care organizations:
• Legal forms
• Governance
11. Transactions with tax-exempts:
• Tax-exempt health care organizations
• Joint ventures with charities
• NFP conversions & sales
