- Eric Stecker,The Oregon ACO Experiment — Bold Design, Challenging Execution, NEJM
- Nicole Huberfeld, Heed Not the Umpire (Justice Ginsburg Called NFIB), SSRN/U. Pa. J. Const. L. Height. Scrutiny.
- Lance Gable, Evading Emergency: Strengthening Emergency Responses through Integrated Pluralistic Governance, SSRN/Oregon L.Rev.
- Susan Wolf, The Challenge of Nanomedicine Human Subjects Research: Protecting Participants, Workers, Bystanders, and the Environment, SSRN/JLME
Category: Nicolas Terry
Final Tally on Insurance Marketplaces
The Commonwealth Fund, here, has a very useful update on state choices for their marketplace types. The importance of these exchanges is noted by the authors: “The Congressional Budget Office estimates that by the end of next year some 9 million people will have enrolled in plans offered through their state marketplace, rising to 25 million by 2022. The majority of the enrollees will also receive premium subsidies.”
The final tally?
- State-run: 17 plus DC
- State-federal partnership: 7
- Federally-facilitated: 26
Worth Reading This Week
- Max Mehlman, Professional Power and the Standard of Care in Medicine, SSRN/Arizona State L.J.
- Mark Rothstein, HIPAA Privacy Rule 2.0, SSRN/JLME
- Benjamin Sommers & Arnold Epstein, Governors and the Medicaid Expansion — No Quick Resolution in Sight, NEJM
- Thad Pope, Clinicians May Not Administer Life-Sustaining Treatment Without Consent: Civil, Criminal, and Disciplinary Sanctions, SSRN/J.Health & Biomedical L.
Worth Reading This Week
- Maxwell Mehlman, Patrick Lin & Keith Abney, Enhanced Warfighters: Risk, Ethics, and Policy, SSRN
- Evelyn Tenenbaum, Revitalizing Informed Consent and Protecting Patient Autonomy: An Appeal to Abandon Objective Causation, SSRN/Oklahoma L.Rev.
- Richard Frank, Using Shared Savings to Foster Coordinated Care for Dual Eligibles, N Engl J Med
- Seth A. Seabury et al, On Average, Physicians Spend Nearly 11 Percent Of Their 40-Year Careers With An Open, Unresolved Malpractice Claim, Health Affairs
Worth Reading This Week
- Douglas L. Rogers, After Prometheus, Are Human Genes Patentable Subject Matter? SSRN
- Douglas McCarthy et al, Recasting Readmissions by Placing the Hospital Role in Community Context, JAMA/Commonwealth Fund
- John Robertson, Paid Organ Donation and the Constitutionality Of the National Organ Transplant Act, SSRN/Hastings Const. L.Q.
Worth Reading This Week
- David Orentlicher & William David, Concussion and Football: Failures to Respond by the NFL and the Medical Profession, SSRN/FIU L.Rev.
- Benjamin Sommers & Arnold Epstein, U.S. Governors and the Medicaid Expansion — No Quick Resolution in Sight, NEJM
- Jonathan Kahn, The Troubling Persistence of Race in Pharmacogenomics, SSRN/JLME
- Alicia Ouellette, Health Reform and the Supreme Court: The ACA Survives the Battle of the Broccoli and Fortifies Itself Against Future Fatal Attack, SSRN/Alb. L. Rev.
Worth Reading This Week
- Barbara Evans, Why the Common Rule is Hard to Amend, SSRN
- Ann Marie Marciarille, Let Fifty Flowers Bloom: Health Care Federalism after National Federation of Independent Business V. Sebelius, SSRN/UMKC L.Rev.
- Tim Jost, Religious Freedom and Women’s Health — The Litigation on Contraception, NEJM
- Elizabeth Sepper, Taking Conscience Seriously, SSRN/Va L Rev
Cross-posted at HealthLawProfs
Worth Reading This Week
- Efthimios Parasidis, Justice and Beneficence in Military Medicine and Research, SSRN/Ohio State LJ
- Sara Rosenbaum, Threading the Needle — Medicaid and the 113th Congress, NEJM
- David Orentlicher, NFIB v. Sibelius: Proportionality in the Exercise of Congressional Power, SSRN
- Karen Rothenberg & Lynn Wein Bush, Manipulating Fate: Medical Innovations, Ethical Implications, Theatrical Illuminations, SSRN/Houston J.Health L. P’cy
- Sallie Thieme Sanford, Designing Model Homes for the Changing Medical Neighborhood: A Multi-Payer Pilot Offers Lessons for ACO and PCMH Construction, SSRN/Seton Hall L. Rev.
Cross-posted at HealthLawProfs
Worth Reading This Week
- Jessica Mantel, Accountable Care Organizations: Can We Have Our Cake and Eat it Too? SSRN
- Kieran Healy & Kimberly Krawiec, Custom, Contract, and Kidney Exchange, SSRN/Duke L.J.
- Eliott Fisher et al, A framework for evaluating the formation, implementation, and performance of accountable care organizations, Health Affairs
- Ronald Bayer et al, Repackaging Cigarettes — Will the Courts Thwart the FDA? NEJM
- Vicki Girard, Reducing Unlawful Prescription Drug Promotion: Is the Public Health Being Served by an Enforcement Approach that Focuses on Punishment? SSRN/FDLI Food & Drug Forum
Cross-posted at HealthLawProfs
Meaningful Scrutiny for Meaningful Use
Today the Office of the Inspector General (OIG) in the Department of Health and Human Services released a report, here, that is decidedly critical of CMS and ONC oversight of the Electronic Health Record (EHR) subsidy program.
Over the last couple of years there have been growing criticisms of the Meaningful Use program and its disbursement of potentially $30 billion in ARRA funds. I have detailed many of these concerns, such as the overall effectiveness of electronic records, my doubts as to the robustness of the first two Stages of Meaningful Use requirements, the safety record of the technologies, their ability to actually save money, their real-world interoperability, and their general usability in the healthcare workflow, here.
Recently, additional questions have been raised that go to the very heart of the subsidy program. First, the Center for Public Integrity, here, and the New York Times, here, set off a firestorm with allegations of EHR use leading to extensive upcoding. This led to a scolding letter to the healthcare industry from Secretary Sebelius and the Attorney-General, here, and combative words back from some of the addressees, here.
Questions have also been raised about the apparent laxity of CMS in approving payment to providers claiming subsidy funds, leading to CMS announcing a hastily designed audit process, here.
Today’s OIG report elaborates on the same basic issue of lax payment safeguards. First, the report finds that CMS has not implemented strong pre-payment safeguards (either by verifying self-reported data or requiring supporting documentation). Second, it suggests that CMS’s proposed post-payment audit program is limited and potentially flawed. Fortunately, CMS/ONC are in broad agreement with the OIG that the EHR technology itself must step up and meaningfully test for meaningful use. In the meantime increased Congressional scrutiny seems a less elegant but likely surrogate.