Volume 3 (1994)
Annals of Health Law
The Health Policy and Law Review of Loyola University Chicago School of Law
Volume 3 (1994)
Editor-in-Chief: John D. Blum, M.H.S., J.D.
Executive Editor: Marilyn Hanzal, J.D.
Senior Editors: Marilyn Hanzal and Jennifer Schima
Editorial Board:
Jack R. Bierig
Christine Cooper
Harold J. Bressler
James M. Gaynor
Marilyn Hanzal
Ilene Johnson
Jeffrey L. Kwall
Robert G. Lee
Jean V. McHale
Marcia Handler Mauro
Patricia Peppin
Gilbert Sharpe
Lawrence E. Singer
Jeffrey M. Teske
Articles:
Antitrust Enforcement Encourages Health Care Providers To Cooperate Procompetitively
Author: David Marx, Jr. & Christopher M. Murphy
A review of significant administrative and judicial rulings in antitrust law during 1993 shows that the antitrust laws should not impede innovative, cost-cutting cooperative arrangements among providers, so long as their actual or potential procompetitive benefits are not outweighed by their anticompetitive effects.
Medicare and GAAP: Understanding the Decision to the Sixth Circuit in Guernsey Memorial Hospital v. Secretary of Health and Human Services
Author: Robert L. Roth
The Medicare Act entitles qualified providers to reimbursement for the "reasonable cost" of furnishing hospital services to Medicare beneficiaries. The Sixth Circuit's decision in Guernsey Memorial Hospital demonstrates the tension between generally accepted accounting principles and Medicare reimbursement principles.
Medicare and Medicaid False Claims: Prohibitions and Sanctions
Author: Timothy Stoltzfus Jost
Both state and federal agencies are cracking down on health care professionals who file false Medicare claims, but physicians who make good faith attempts to comply with the law are fairly secure from prosecution, since both criminal and civil penalties must be based on willful or knowing breaches of the law.
Judicial Review of Medicaid Hospital and Nursing Home Reimbursement Methodologies Under the Boren Amendment
Author: John M. Burman
Congress passed the Boren Amendment to allow states to develop and implement alternative reimbursement methodologies that promote the efficient and economical delivery of hospital and nursing facility services. However, courts have interpreted Boren in ways that limit state discretion and impede their ability to meet budgetary constraints.
The Case for Physician Direction in Health Plans
Author: Edward Hirshfeld
Advanced managed care organizations limit costs by having nonphysician managers make medical management decisions. Physicians should be included on the board of medical managers to assure that the patients' best interests are considered when management decisions are made.
Comparative Health Law Articles
Medical Malpractice and Physician Accountability: Trends in the Courts and Legislative Responses
Author: Theodore R. LeBlang
Efficacious or Precarious' Comments on the Processing and Resolution of Medical Malpractice Claims in the United States
Author: Catherine S. Meschievitz
Malpractice and the Presuppositions of Medical Practice
Author: David T. Ozar
Exponential Change: Today Is Already Tomorrow
Author: Jack R. London
The Efficacy of the Medical Malpractice System: A Canadian Perspective
Author: Gerald B. Robertson
Overview of Medical Malpractice Law in Canada
Author: Joan M. Gilmour
Economic Aspects of Medical Negligence in the Context of the National Health Service in Britain
Author: Stephen L. Heasell
Medical Malpractice: An Overview of the English Position
Author: John Hodgson
An Evaluation of the Danish No-Fault System for Compensating Medical Injuries
Author: Ann Ulrich
Annals of Health Law
The Health Policy and Law Review of Loyola University Chicago School of Law
Volume 3 (1994)
Editor-in-Chief: John D. Blum, M.H.S., J.D.
Executive Editor: Marilyn Hanzal, J.D.
Senior Editors: Marilyn Hanzal and Jennifer Schima
Editorial Board:
Jack R. Bierig
Christine Cooper
Harold J. Bressler
James M. Gaynor
Marilyn Hanzal
Ilene Johnson
Jeffrey L. Kwall
Robert G. Lee
Jean V. McHale
Marcia Handler Mauro
Patricia Peppin
Gilbert Sharpe
Lawrence E. Singer
Jeffrey M. Teske
Articles:
Antitrust Enforcement Encourages Health Care Providers To Cooperate Procompetitively
Author: David Marx, Jr. & Christopher M. Murphy
A review of significant administrative and judicial rulings in antitrust law during 1993 shows that the antitrust laws should not impede innovative, cost-cutting cooperative arrangements among providers, so long as their actual or potential procompetitive benefits are not outweighed by their anticompetitive effects.
Medicare and GAAP: Understanding the Decision to the Sixth Circuit in Guernsey Memorial Hospital v. Secretary of Health and Human Services
Author: Robert L. Roth
The Medicare Act entitles qualified providers to reimbursement for the "reasonable cost" of furnishing hospital services to Medicare beneficiaries. The Sixth Circuit's decision in Guernsey Memorial Hospital demonstrates the tension between generally accepted accounting principles and Medicare reimbursement principles.
Medicare and Medicaid False Claims: Prohibitions and Sanctions
Author: Timothy Stoltzfus Jost
Both state and federal agencies are cracking down on health care professionals who file false Medicare claims, but physicians who make good faith attempts to comply with the law are fairly secure from prosecution, since both criminal and civil penalties must be based on willful or knowing breaches of the law.
Judicial Review of Medicaid Hospital and Nursing Home Reimbursement Methodologies Under the Boren Amendment
Author: John M. Burman
Congress passed the Boren Amendment to allow states to develop and implement alternative reimbursement methodologies that promote the efficient and economical delivery of hospital and nursing facility services. However, courts have interpreted Boren in ways that limit state discretion and impede their ability to meet budgetary constraints.
The Case for Physician Direction in Health Plans
Author: Edward Hirshfeld
Advanced managed care organizations limit costs by having nonphysician managers make medical management decisions. Physicians should be included on the board of medical managers to assure that the patients' best interests are considered when management decisions are made.
Comparative Health Law Articles
Medical Malpractice and Physician Accountability: Trends in the Courts and Legislative Responses
Author: Theodore R. LeBlang
Efficacious or Precarious' Comments on the Processing and Resolution of Medical Malpractice Claims in the United States
Author: Catherine S. Meschievitz
Malpractice and the Presuppositions of Medical Practice
Author: David T. Ozar
Exponential Change: Today Is Already Tomorrow
Author: Jack R. London
The Efficacy of the Medical Malpractice System: A Canadian Perspective
Author: Gerald B. Robertson
Overview of Medical Malpractice Law in Canada
Author: Joan M. Gilmour
Economic Aspects of Medical Negligence in the Context of the National Health Service in Britain
Author: Stephen L. Heasell
Medical Malpractice: An Overview of the English Position
Author: John Hodgson
An Evaluation of the Danish No-Fault System for Compensating Medical Injuries
Author: Ann Ulrich