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. Key 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.

This book is designed for a specialized health law course focusing on the organization and finance of health care. It is also well-suited for health law courses in health administration or management programs. The 7th Edition focuses heavily on the many changes that the Affordable Care Act is bringing about in the regulation of health care and health insurance. The book begins with an introduction to fundamental concepts affecting health law and policy, and then explores conventional and emerging methods of quality control regulation applicable to health care professionals and health care institutions. The next section of the book examines in depth the policy and legal issues presented by varying approaches to providing access to health care and controlling its cost. This section explores in depth the provisions of the Affordable Care Act that are expanding access to health care, and analyzes the challenges to that law, including the National Federation of Independent Business Supreme Court decision. This section also considers legal issues presented by private health insurance, managed care, Medicare, and Medicaid, as well as obligations to provide medical services under state and federal law. The final section of the book explores legal issues that affect health care institutions and the relationships between professionals and institutions, including medical staff privileging, physician-hospital contracting, accountable care organizations, employment and labor law, tax exempt organization law, fraud and abuse issues, and antitrust law. The 7th edition has been completely updated, covering recent developments involving consumer-driven health care, ERISA, antitrust enforcement, labor law, and tax-exempt organization law, in addition to the Affordable Care Act developments.

Health Care Law and Ethics, Ninth Edition offers a relationship-oriented approach to health law—covering the essentials, as well as topical and controversial subjects. The book provides thoughtful and teachable coverage of every aspect of health care law. Current and classic cases build logically from the fundamentals of the patient/provider relationship to the role of government and institutions in health care. The book is adaptable to both survey courses and courses covering portions of the field. Key Features: New authors Nick Bagley and Glenn Cohen Incorporated anticipated changes to the Affordable Care Act More current cases and more streamlined notes, including ones on medical malpractice, bioethics, and on finance and regulation More coverage of “conscientious objection” and “big data” - Discussion of new “value based” methods of physician payment - Expanded coverage of “fraud and abuse” Current issues in public health (e.g., Ebola, Zika) and controversies in reproductive choice (e.g., Hobby Lobby) Coverage of cutting-edge genetic technologies (e.g., gene editing and mitochondrial replacement)

Regulation shapes all aspects of America's fragmented health care industry. While the health and lives of patients as well as almost one-sixth of the national economy depend on its effectiveness, health care regulation in America is bewilderingly complex. 'Health Care Regulation in America' is a guide to this regulatory maze.

This book is designed for a specialized health law course focusing on the organization and financing of health care. It is also well-suited for health law courses in health administration, business, or health policy and management programs. The book begins with an introduction to fundamental concepts affecting cost, quality, access, and equity in health care and sets out the economic principles and tools used in health policy and reform efforts. The book includes extensive coverage of payment systems, including Medicare, Medicaid, and private insurance and their effect on the organization of the health care delivery system, including alternative payment models, such as accountable care organizations. The book also surveys the organizational structures and legal relationships in health care enterprises. The book explores legal concerns affecting the payment and delivery of health care, including the continuing impact of the Affordable Care Act, up-to-date coverage of fraud and abuse laws, antitrust enforcement, ERISA, and requirements for tax-exempt entities. Several chapters examine the legal framework for quality control efforts, including professional licensure, institutional licensure and certification, and nondiscrimination requirements. As in previous editions, the authors provide classroom teaching tools including problems that engage students in dealing with legal, policy, and practical issues and a range of materials drawn from judicial opinions, statutes, regulations, agency guidance, and other sources.

Examining the ways and extent to which systemic factors affect health outcomes with regard to quality, affordability and access to curative healthcare, this explorative book compares tax-funded Beveridge systems and insurance-based Bismarck systems. Containing contributions from national experts, The Law and Policy of Healthcare Financing charts and compares the merits of healthcare systems throughout 11 countries, from the UK to Colombia.