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Journal Article
J Health Polit Policy Law (1980) 5 (3): 498–513.
Published: 01 June 1980
...Kathryn M. Langwell; Jack L. Werner The problem of professional liability claims and impact on the medical care market has become increasingly important in recent years. Professional liability insurance premiums, and the practice of defensive medicine by physicians in response to potential...
Journal Article
J Health Polit Policy Law (1984) 9 (3): 475–488.
Published: 01 June 1984
...E. Kathleen Adams; Stephen Zuckerman This study analyzes the incidence of medical malpractice claims since 1976. using data drawn from the 1982 core survey of the American Medical Association's Socioeconomic Monitoring System. The data show that, on average, physicians incurred twice as many claims...
Journal Article
J Health Polit Policy Law (2010) 35 (6): 921–959.
Published: 01 December 2010
... uniformly. © 2011 by Duke University Press 2011 Images of Illness: How Causal Claims and Racial Associations Influence Public Preferences toward Diabetes Research Spending...
Journal Article
J Health Polit Policy Law (2000) 25 (2): 283–308.
Published: 01 April 2000
.... The DOJ's primary weapon in prosecuting health care fraud is the federal False Claims Act (FCA) of 1863 (31 U.S.C. secs. 3729–3733). Almost unique among federal antifraud provisions, the FCA may also be used by “private prosecutors” to file lawsuits on behalf of the federal government charging organizations...
Journal Article
J Health Polit Policy Law (1985) 9 (4): 731–735.
Published: 01 August 1985
...Frank S. Bloch Jerry L. Mashaw, Bureaucratic Justice: Managing Social Security Disability Claims (New Haven and London: Yale University Press, 1983), 238 pp., $25.00 Copyright © 1985 by the Department of Health Administration, Duke University Press 1985 Jerry L. Mashaw...
Journal Article
J Health Polit Policy Law (2021) 46 (4): 677–701.
Published: 01 August 2021
... policy and whether its command of professional knowledge enables the profession to claim exclusive authority for reflecting on health policy. This article analyzes and compares how medical associations claim authority over health policy and how they reposition their claims in light of perceived...
Journal Article
J Health Polit Policy Law (2017) 42 (1): 5–52.
Published: 01 February 2017
... of rising prices through direct regulation at the state level. Yet this literature fails to account for how change agents in the states gradually reconfigured the politics of prices, forging new, transparency-based policy instruments called all-payer claims databases (APCDs), which are designed to empower...
Journal Article
J Health Polit Policy Law (2020) 45 (3): 419–437.
Published: 01 June 2020
...David Howard Abstract Context: Overtreatment is costly, but is it fraud? In a growing number of False Claims Act cases, the Department of Justice has sought and received multimillion dollar settlements from providers accused of billing Medicare for unnecessary care. This article evaluates the use...
Journal Article
J Health Polit Policy Law (2008) 33 (4): 761–798.
Published: 01 August 2008
...: Is there federal authority to preempt state law (the commerce clause and spending clause issues)? May jurisdiction be created in non - article 3 tribunals, and may claims be decided without trial by jury (the separation of powers and Seventh Amendment issues)? Would pilot programs that require some claims...
Journal Article
J Health Polit Policy Law (1989) 14 (4): 663–689.
Published: 01 August 1989
... reforms enacted during the 1970s have had on the probability that a claim will be paid, the amount of payment, and the speed with which the claim is resolved. Claims frequency is not used as a variable in this analysis, but findings from other studies pertaining to frequency are noted. This study uses two...
Journal Article
J Health Polit Policy Law (1991) 16 (3): 441–464.
Published: 01 June 1991
...William P. Gronfein; Eleanor DeArman Kinney Indiana's comprehensive malpractice reforms, inaugurated in 1975, include a cap on damages, a mandated medical review before trial, and a state insurance fund to pay claims equal to or greater than $100,000. We have found that the amount of compensation...
Journal Article
J Health Polit Policy Law (2007) 32 (5): 843–865.
Published: 01 October 2007
... of plaintiffs, attorneys, medical providers, and malpractice insurers in the intended way is crucial to policy makers, if they are to achieve their goal. This study specifically examines the effect of reforms on the claims defense efforts of insurers, given that defense expenses account for approximately 30...
Journal Article
J Health Polit Policy Law (2002) 27 (5): 833–854.
Published: 01 October 2002
..., and thus may both reduce barriers to compensation and increase disclosure of error. Little evidence, however, is available on the performance of such systems. This article reports on the analysis of two data sources—a sample of hospital admissions and a complete set of compensation claims for medical...
Journal Article
J Health Polit Policy Law (1999) 24 (1): 161–180.
Published: 01 February 1999
...: What Advocates and Critics Have Claimed and What Oregon Did Lawrence Jacobs University of Minnesota...
Journal Article
J Health Polit Policy Law (2023) 48 (1): 93–115.
Published: 01 February 2023
... of state-based all-payer claims databases (APCDs). APCDs are health data organizations that hold transactional information from public (Medicare and Medicaid) and private health insurers (commercial plans and some self-insured employers). APCDs transform this data into useful information on health care...
Published: 01 June 2020
Figure 1 New health care False Claims Act cases. Source : Civil Division, US Department of Justice. Fraud Statistics—Overview, www.justice.gov/opa/press-release/file/918361/download . More
Published: 01 August 2017
Figure 1 Pathways for Introduction of Novel or Altered Products under the FSPTCA Note : For products claiming modified or reduced risk, a separate pathway exists under section 911. More
Published: 01 June 2022
Figure 1 Commercial and Medicaid coverage in Wisconsin, April 2013–December 2016. Notes : Commercial graphed on left axis; Medicaid on right axis. Reference gridlines have same change in level. Source : Authors' analysis of Wisconsin Health Information Organization all-payer claims data. More
Journal Article
J Health Polit Policy Law (1995) 20 (1): 49–74.
Published: 01 February 1995
...-allowed charges as payment in full. Only nonparticipating physicians are permitted to bill for additional amounts beyond that paid by Medicare, and there are limits on the amount of balance billing per claim. As shown by the analysis of claims presented in this article, Medicare has successfully provided...
Journal Article
J Health Polit Policy Law (2014) 39 (1): 247–258.
Published: 01 February 2014
...Pilar N. Ossorio; J. Paul Kelleher Abstract Perry Payne argues that the health care system should encourage provision of whole genome sequencing (WGS) for most people in the near future. Payne's essay contains two distinct claims. One claim is that near-universal access to WGS would be beneficial...