The Law of Health Care Finance & Regulation 3e / Edition 3

by Mark A. Hall, Mary Anne Bobinski

Overview

The Law of Health Care Finance and Regulation is based on Part III—Institutions, Providers, and the State—of parent book Health Care Law and Ethics, and adds additional coverage of a variety of issues that have shaped health care finance law. Integrating public health, financial and ethical issues, this casebook uses compelling case law, clear notes and comprehensive background information to illuminate the complex and dynamic field of health care law.

The Third Edition has been thoroughly updated to cover the Affordable Care Act, the new health care reform legislation that is changing public policy and shaping new legal, ethical and financial relationships between patients, providers, institutions and the government.

Features:

• Based on material in Part III of the popular parent book, Institutions, Providers, and the State— along with coverage of duty to treat, hospital liability, managed care liability, and regulating access to drugs.
• Includes cases and material not found in the parent book on:
• Judicial and administrative review of Medicare decisions.
• Certificate of need laws.
• Review immunity.
• Integrates public health and ethics issues and features clear notes that provide context, smooth transitions between cases, and background information.
• Website provides background materials, updates of important events, additional relevant topics and links to other resources on the Internet.

The Third Edition has been updated to provide:

• Thorough coverage of the Affordable Care Act, including:
• Overview and politics of enactment.
• Constitutional challenges.
• Insurance exchanges and regulation.
• Medicaid expansions and Medicare amendments.
• Accountable care organizations.
• Comparative effectiveness studies.
• Cost containment.

Product Details

ISBN-13:	9781454805342
Publisher:	Wolters Kluwer Law & Business
Publication date:	08/15/2013
Edition description:	Older Edition
Pages:	700
Product dimensions:	7.40(w) x 9.90(h) x 1.00(d)

Table of Contents

Summary of Contents

Ch. 1. Introduction

A. Overview of Cases

B. The Nature of Medical Practice

C. The Health Care Financing and Delivery System

D. Moral, Economic, and Political Themes

Ch. 2. Institutional Liability

A. The Duty to Treat

B. Hospital Liability

C. Managed Care Liability

Ch. 3. Health Care Financing and Reform

A. Sources of Health Insurance

B. Insurance and HMO Regulation

C. ERISA Preemption

D. Health Insurance Coverage

E. Provider Reimbursement

F. Health Insurance Reform

Ch. 4. Regulation of Health Care Facilities and Transactions

A. Professional and Facility Regulation

B. Corporate Form

C. Medical Staff Structure

D. Antitrust Law

E. Referral Fee Laws

Glossary of Organizational Terms and Acronyms

Table of Cases

Index