Current Issues in Health Law and Policy

Catalog description

The course begins with a study of statutes, regulations, and cases concerning licensure, informed consent (to treatment), and liability. We also examine law and policy governing health care affordability and accessibility, including insurance coverage, and bioethical dimensions of health care. Having set the stage with these foundations of health law, the course will focus on the role of technology in varied settings of health policy, law, and regulation. These topics change year to year and may include: reimbursement levels set by the Centers for Medicare and Medicaid Services for new technology; quality analysis for Accountable Care Organizations and other Advanced Payment Models; calculation of medical loss ratios and other critical quantitative analysis for private insurers; quality measures for providers and hospitals; data analytics for public health measures; FDA assessments of drug safety and effectiveness; rankings and ratings of physicians and hospitals; statistical assessment of patterns of fraud and abuse; the role of data in Advanced Payment Models and other pay for performance alternatives to fee-for-service; the role of middlemen such as pharmacy benefit managers and group purchasing organizations in larger networks of health care finance; sampling cases for False Claims Act liability; proper information about outcomes for informed consent and reimbursement purposes; drug effectiveness and approvals; valuation of procedures via the resource-based relative value scale method; prior authorization for treatment; and COVID-19 data disputes. In many of these areas, we will consider the role of big data, AI, and machine learning in collecting, analyzing, and using health data.