October 25, 2012
Follow up On Fungal Meningitis Outbreak
For those following the investigation of the meningitis outbreak the Massachusetts Department of Public Health has issued a preliminary report which links the outbreaks to apparently unsterile conditions at the New England Compounding Center (NECC). Meanwhile, confirmed cases continue with the latest being identified in South Carolina. Most recently, the CDC reports that the death toll is now 24. The CDC now believes that “patients are most at risk for developing fungal meningitis within the first 6 weeks (42 days) after receiving their last injection in the back (epidural or paraspinal) with contaminated steroid medication from the New England Compounding Center.” The blog Pharma Watchdog continues to monitor this and other pharmaceutical related legal issues. If this case has sparked particular interest for someone not already involved in teaching public health law, the American Public Health Association has some terrific resource material on Public Health Law in general.
Concluding with more on the topic of public health, this weekend marks the beginning of the APHA’s annual meeting which takes place this year in San Francisco. As always, the law section is offering a plethora of high quality programs. I will be there and look forward to seeing other health law profs.
Care for Vulnerable PopulationsThe Commowealth Fund has released a short video, here, on the subject of Improving Care for Vulnerable Populations.They also have more information, including a classroom-friendly chartpack on Care for Low-Income Populations here. [NPT]
And now, the important stuff...
If you tend to cure your mid-semester slump by increased chocolate consumption, here's a study to back you up. A study published recently in the New England Journal of Medicine found "There was a close, significant linear correlation (r=0.791, P<0.0001) between chocolate consumption per capita and the number of Nobel laureates per 10 million persons in a total of 23 countries." The study concludes:
Chocolate consumption enhances cognitive function, which is a sine qua non for winning the Nobel Prize, and it closely correlates with the number of Nobel laureates in each country. It remains to be determined whether the consumption of chocolate is the underlying mechanism for the observed association with improved cognitive function.
October 24, 2012
Medicare Reportedly Settles on Coverage for Rehabilitative Services
For many years, Medicare has refused to pay for physical or occupational therapy unless patients could show "improvement." Although this policy is a cost-saver, it has devastating effects on patients for whom these therapies are critical to maintaining current levels of functioning or preventing declines. The "benefits" of care extend far beyond "improvement."
Over the years, there have been some changes. For example, many local Medicare carriers routinely denied ANY physical therapy to patients with a diagnosis of Alzheimer's disease, apparently on the theory that people with declining cognitive capacities cannot benefit from the service. Leslie Fried, an lawyer at the ABA's Commission on Law and Aging (at the time the Commission on the Legal Problems of the Elderly) and partially funded by the Alzheimer's Association, took on these policies, http://www.alz.org/professionals_and_researchers_insurance_and_coverage.asp. A photograph of President Reagan leaving physical therapy after his hip replacement (and long after the public announcement of his diagnosis of Alzheimer's) helped her to get Medicare to change such across-the-board denials. However, the overall policy that patients must show "improvement" continued. The Medicare Part B manual (current as of spring, 2012), reads: "Rehabilitative therapy includes recovery or improvement in function and, when possible, restoration to a previous level of health and well-being. Therefore, evaluation, re- evaluation and assessment documented in the progress report should describe objective measurements which, when compared, show improvements in function or decrease in severity or rationalization for an optimistic outlook to justify continued treatment."
This policy was challenged in federal district court in Vermont by lawyers at the Center for Medicare Advocacy. The Obama administration reportedly agreed earlier this week to settle the case, by stating in the Medicare manual that coverage for rehabilitative services: "does not turn on the presence or absence of a beneficiary's potential for improvement from the therapy, but rather on the beneficiary's need for skilled care." News reports indicate that Medicare is describing this as a "clarification" of existing policy. If it is such a clarification--and the language quoted above from the current manual would suggest it is far more than that--it is a welcome one, with the potential to benefit many Medicare recipients with chronic or disabling conditions.
October 22, 2012
Health Affairs on Comparative Effectiveness Research
In the effort to promote higher-quality, lower-cost health care, the Affordable Care Act rightly emphasizes comparative effectiveness research. Studies often demonstrate that different treatments are effective for a medical problem without telling us which treatment is best. More studies comparing different treatments can make for better medical decisions. The current issue of Health Affairs includes a number of helpful articles on the challenges to implementing an effective comparative effectiveness research policy.
October 21, 2012
Naomi Schoenbaum: The Single Word That Could Make or Break Obamacare
Naomi Schoenbaum, Associate Professor of Law, George Washington University Law School has written a very interesting essay for The Atlantic on the implications of labeling the health care mandate a tax or a penalty. Below is an excerpt. The entire essay is here.
Obamacare has been one of the yardsticks of Obama's term in office and one of the touchstones of the 2012 election. Last night's presidential debate was no exception, with health care reform mentioned at least half a dozen times. But an important piece of the discussion has been missing: is the health care law a tax or a penalty?
It turns out how Americans perceive the health care mandate could affect whether they end up purchasing health insurance at all, and therefore whether the law achieves what it was meant to do. During the next four years, the way the president chooses to frame the law will have a large impact on its policy future.
Position Announcement: University of Georgia Law School - Medical-Legal Partnership Clinic
The University of Georgia School of Law seeks a tenure-track assistant professor to serve as the director of a to-be-created Medical-Legal Partnership (MLP) Clinic, beginning the 2013 – 2014 academic year. Job expectations include both clinical work and the production of academic scholarship.
On the scholarship side, the director must be able to satisfy all the standards applicable to other members of the tenure-track faculty, including the production of first-rate scholarship published in major law reviews.
On the clinical side, the successful applicant will be responsible for establishing partnership(s) with medical providers in the community to house the new MLP Clinic. The goal of the MLP Clinic is to provide legal services to underserved individuals receiving treatment from the medical provider. Responsibilities include managing the partnership relationship, teaching the classroom component of the Clinic, and supervising student legal work in the Clinic.
Finally, the director will teach a related doctrinal course.
Applicants must possess a J.D. or equivalent law degree and must be a member of the Georgia Bar or willing to become a member as soon as practical following appointment. Applications should include a cover letter, resume or CV, description of scholarly research agenda, existing scholarship and references. The University of Georgia is an equal opportunity employer and strongly encourages candidates from diverse backgrounds to apply.
Contact: Professor Erica Hashimoto, University of Georgia, School of Law, Herty Drive, Athens, GA 30602. (706) 542-5098, firstname.lastname@example.org