Gorsuch On Sidelines As Supreme Court Decides Insurance, Legal Sanctions Cases

Forbes, 18 April 2017
Author: Daniel Fisher
“The U.S. Supreme Court issued a pair of decisions today affecting legal sanctions and the power of states to control insurance contracts, noting in each one the non-participation of the court’s newest Justice, Neil Gorsuch.”
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(re Dargan) Amaca Pty Limited v Northern Sydney Area Health Service & Ors [2017] NSWDDT 1

Decision date: 16 March 2017
“Dust Diseases – cross claim – mesothelioma – statutory compensation paid to plaintiff by WorkCover Queensland – agreement between WorkCover Queensland and plaintiff that in proceedings against Amaca Pty Limited, plaintiff may retain 20% of proceeds if proceeds less than compensation received – proceedings by plaintiff against Amaca Pty Limited – plaintiff’s proceedings settled for less than compensation received – whether the agreement resulted in plaintiff receiving double compensation – if so, whether Amaca Pty Limited and cross defendants were not “liable in respect of (the) damage” suffered by the plaintiff within the meaning of s 5 Law Reform (Miscellaneous Provisions) Act 1946 (NSW) such that Amaca Pty Limited could not claim contribution from the cross defendants.”
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What Can US Policymakers Learn About Essential Health Benefits From Israel?

Health Affairs Blog, 23 March 2017
Authors: Rachel Nisanhotz, David Chinitz, Sara Rosenbaum
“US policymakers confronting these complex questions could benefit from a close look at how other health systems approach them. In particular, it may surprise readers to know that Israel has a system very much in line with many US policymakers’ goals of fostering a competitive private insurance market. The Israeli system rests on the concept of competing private health plans selling care in a market of empowered consumers. But one crucial difference is how Israel approaches the question of what it means to be covered.”
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Prisoners are excluded from the NDIS – here’s why it matters

The Conversation, 14 March 2017
Author: Jesse Young, Stuart Kinner
“The National Disability Insurance Scheme (NDIS) is designed to provide access to personalised supports and services for all Australians with a disability. However, the NDIS specifically excludes prisoners.”
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The Loopholes in the Law Prohibiting Genetic Discrimination

The Atlantic, 14 March 2017
Author: Sarah Zhang
“When the Genetic Information Nondiscrimination Act passed in 2008, supporters hailed it as the “first major civil-rights bill of the century.” GINA was unusually forward-looking; it protected against a form of discrimination that was not yet common. Under the law, employers and health insurance companies could not request genetic test results and discriminate based upon them.”
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How Will People Who Are Already Sick Be Treated Under A New Health Law?

NPR, 13 March 2017
Author: Julie Rovner
“The Affordable Care Act (ACA) made it illegal for insurers to deny or charge people more money because of a history of illness. That’s a pretty big deal because an estimated 52 million American adults have such conditions – ranging from serious ailments like diabetes and HIV to more minor maladies like acne or seasonal allergies. Before the ACA, people with these conditions were often denied insurance. If they were offered insurance, it could cost more or didn’t include coverage of their condition.”
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Annals for Hospitalists Inpatient Notes – Legislating Quality to Prevent Infection—A Primer for Hospitalists

Ann Intern Med. 2017;166(4):HO2-HO3.
Authors: Jennifer Meddings, MD, MSc; Laurence F. McMahon, Jr.,
“Three major Medicare policies now target rates of catheter-associated urinary tract infection (CAUTI) and central line–associated bloodstream infection (CLABSI) as performance measures in hospitals. These Medicare value-based purchasing programs are designed to levy financial penalties to hospitals, based on infection rates. Mandated by federal law, the goal of these programs is to motivate hospitals to improve safety while guaranteeing Medicare savings. Like many federal laws, these programs are complex, quickly implemented without prior validation, and poorly understood by the people who are directly affected—patients and clinicians.”
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UnitedHealth sued by U.S. government over Medicare charges

Reuters, 17 February 2017
Author: Akankshita Mukhopadhyay, Laharee Chatterjee
“The U.S. Justice Department has joined a whistleblower lawsuit against UnitedHealth Group Inc that claims the country’s largest health insurer and its units and affiliates overcharged Medicare hundreds of millions of dollars, a law firm representing the whistleblower said on Thursday.”
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