Health Care Law

Overview

Health care aims to prevent and treat illness and disease in order to maintain the physical and mental well-being of individuals. Nearly all industrialized nations provide universal, publicly-funded health care through a national system. The exception is the United States, where health care is largely provided by the private sector, although some public services are available for certain individuals.

State statutes comprise a large portion of law applicable to health care. State health care law ranges from regulation of the health insurance industry to rules governing cases of medical malpractice. State agencies and departments are usually responsible for implementing state health laws and regulations, as well as administering certain federally-funded health care programs.

The Public Health and Welfare Act contains a significant portion of federal health care law. It focuses largely on the Department of Health and Human Services (DHH), which is the main federal agency devoted to health protection and services, particularly for those who are most vulnerable. The DHH has more than three hundred programs, including the National Institutes of Health (NIH), which conducts and funds medical research, and the Centers for Medicare and Medicaid Services, which direct the Medicaid and Medicare programs that provide medical care to those who are elderly, disabled, or poor. Of the nearly $700 billion annual budget of the DHH, the Centers for Medicaid and Medicare Services receive close to $500 billion dollars. Medicaid and Medicare each provide health coverage to over 40 million individuals.

Medicaid, which seeks to assist low-income individuals, is a federal program funded by both federal and state funds, but is administered by the states alone. States regulate the delivery of health care services under the program. Individuals may only receive Medicaid if they meet the conditions for eligibility promulgated by the state in which the individual resides; therefore, not all people with low incomes qualify. State criteria for Medicaid may include factors such as pregnancy, blindness, or disability. Eligibility may also depend upon the individual's age, income, assets, resources, or lawful immigration status. Several states have their own separate programs that provide medical care for low-income persons who do not qualify for Medicaid.

Although state law determines eligibility and distribution of Medicaid services, some federal law limits state discretion. For example, federal law forbids states from reducing welfare benefits based on the receipt of Medicaid services. Federal law allows states to require residency in a state in order to qualify for its Medicare services; however, states may not restrict benefits based on citizenship or employment status. Additionally, federal law criminalizes fraudulent Medicaid claims by recipients and providers.

Medicare differs from Medicaid in that Medicare is an actual insurance program. It is federal health insurance made available to people over age 65. Additionally, Medicare is available to persons under 65 possessing certain disabilities, and for all people with end-stage renal disease (kidney failure). Medicaid encompasses insurance coverage for hospital and medical services. Most people must pay a monthly premium for the medical services portion of Medicare. An optional Prescription Drug plan, for which most people must also pay a monthly premium, covers prescription medication.

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Featured Cases

GUNVALSON et al v. PTC THERAPEUTICS, INC.
Plaintiffs Cheri and John Gunvalson, parents of Jacob Gunvalson, sought an order requiring Defendant PTC Therapeutics, Inc. to permit Jacob to participate as a protocol exception in the Phase IIa study extension for PTC124 for Duchenne Muscular Dystrophy. Alternatively, Plaintiffs sought an order that Defendant make available PTC124 to Jacob's pediatrician.
New Jersey District Court
Plaintiff
Filed: July 16, 2008
Plaintiff: JACOB GUNVALSON, CHERI AND JOHN GUNVALSON; Defendant: PTC THERAPEUTICS, INC.
Last Docket Filed: April 7, 2009
(April 6, 2009)

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Legislation

Bill Enacted: H.R.3288 Department of Transportation Appropriations Act, 2010
Making appropriations for the Departments of Transportation, and Housing and Urban Development, and related agencies for the fiscal year ending September 30, 2010, and for other purposes.
December 16, 2009: Became Public Law No: 111-117.
(December 14, 2009)
Bill Introduced: S.2860 A bill to protect students from inappropriate seclusion and physical ...
A bill to protect students from inappropriate seclusion and physical restraint, and for other purposes.
(December 7, 2009)
Bill Introduced: H.R.4247 Preventing Harmful Restraint and Seclusion in Schools Act
To prevent and reduce the use of physical restraint and seclusion in schools, and for other purposes.
(December 7, 2009)
Bill Introduced: H.R.4222 Prevent Health Care Fraud Act of 2009
To provide for the establishment of the Office of Deputy Secretary for Health Care Fraud Prevention.
(December 6, 2009)
Bill Introduced: H.R.4190 Endocrine Disruption Prevention Act of 2009
To amend the Public Health Service Act to authorize the National Institute of Environmental Health Sciences to conduct a research program on endocrine disruption, to prevent and reduce the production of, and exposure to, chemicals that can undermine the development of children before they are born and cause lifelong impairment to their health and function, and for other purposes.
(December 1, 2009)

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Regulations

Rule - Listing of Color Additives Exempt From Certification: Astaxanthin Dimethyldisuccinate; ...
Food and Drug Administration
Rule
Listing of Color Additives Exempt From Certification:
Astaxanthin Dimethyldisuccinate; Confirmation of Effective Date
,
5887 [2010-2522]
DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 73 [Docket No. FDA-2007-C-0044] (formerly Docket No. 2007C-0474) Listing of Color Additives Exempt From Certification; Astaxanthin Dimethyldisuccinate; Confirmation of Effective Date AGENCY: Food and Drug Administration, HHS. ACTION: Final rule; confirmation of effective date. SUMMARY: The Food and Drug Administration (FDA) is confirming the effective date of December 8, 2009, for the final rule that appeared in... [read document]
View Document | Download PDF
(February 4, 2010)
Rule - Listing of Color Additives Exempt From Certification: Paracoccus Pigment; Confirmation ...
Food and Drug Administration
Rule
Listing of Color Additives Exempt From Certification:
Paracoccus Pigment; Confirmation of Effective Date
,
5887 [2010-2521]
DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 73 [Docket No. FDA-2007-C-0456] (formerly Docket No. 2007C-0245) Listing of Color Additives Exempt From Certification; Paracoccus Pigment; Confirmation of Effective Date AGENCY: Food and Drug Administration, HHS. ACTION: Final rule; confirmation of effective date. SUMMARY: The Food and Drug Administration (FDA) is confirming the effective date of December 17, 2009, for the final rule that appeared in the Federal... [read document]
View Document | Download PDF
(February 4, 2010)
Rule - Listing of Color Additives Exempt From Certification: Ractopamine; Monensin
Food and Drug Administration
Rule
Listing of Color Additives Exempt From Certification:
Ractopamine; Monensin
,
5887-5888 [2010-2427]
DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 558 [Docket No. FDA-2010-N-0002] New Animal Drugs for Use in Animal Feeds; Ractopamine; Monensin AGENCY: Food and Drug Administration, HHS. ACTION: Final rule. SUMMARY: The Food and Drug Administration (FDA) is amending the animal drug regulations to reflect approval of an original new animal drug application (NADA) filed by Elanco Animal Health, A Division of Eli Lilly and Co. The NADA provides for use of... [read document]
View Document | Download PDF
(February 4, 2010)
Rule - Interim Final Rules under the Paul Wellstone and Pete Domenici Mental Health Parity and ...
Centers for Medicare and Medicaid Services
Rule
Interim Final Rules under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (of 2008)
,
5410-5451 [2010-2167]
Tuesday, February 2, 2010 Part IV Department of the Treasury Internal Revenue Service 26 CFR Part 54 Department of Labor Employee Benefits Security Administration 29 CFR Part 2590 Department of Health and Human Services Centers for Medicare and Medicaid Services 45 CFR Part 146 Interim Final Rules Under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008; Final Rule DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 54 [TD 9479] RIN... [read document]
View Document | Download PDF
(February 1, 2010)
Rule - Implantation or Injectable Dosage Form New Animal Drugs: Miconazole, Polymixin B, and ...
Food and Drug Administration
Rule
Implantation or Injectable Dosage Form New Animal Drugs:
Miconazole, Polymixin B, and Prednisolone Suspension
,
4692-4693 [2010-1794]
DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 524 [Docket No. FDA-2010-N-0002] Ophthalmic and Topical Dosage Form New Animal Drugs; Miconazole, Polymixin B, and Prednisolone Suspension AGENCY: Food and Drug Administration, HHS. ACTION: Final rule. SUMMARY: The Food and Drug Administration (FDA) is amending the animal drug regulations to reflect approval of a new animal drug application (NADA) filed by Janssen Pharmaceutica NV. The NADA provides for use of... [read document]
View Document | Download PDF
(January 28, 2010)

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Articles

An Inquiry into the Theory, Causes and Consequences of Monitoring Indicators of Health and ...
IZA Discussion Paper No. 4734 Kostas Pouliakas and Ioannis Theodossiou University of Aberdeen - Business School and University of Aberdeen - Business School Date Posted: February 8, 2010 Last Revised: February 8, 2010
(February 7, 2010)
Reaching Out to Do Justice: The Rise and Fall of the Special Docket of the U.S. Supreme Court
Arizona Legal Studies Discussion Paper No 10-04 Gabriel J. Chin and Sara Lindenbaum University of Arizona James E. Rogers College of Law and University of Arizona - James E. Rogers College of Law Date Posted: February 8, 2010 Last Revised: February 8, 2010
(February 7, 2010)
State Law Responses to Global Warming: Is It Constitutional to Think Globally and Act Locally?
Pace Environmental Law Review, Vol. 21, pp. 53-81, 2003 David Hodas Widener University - School of Law Date Posted: February 8, 2010 Last Revised: February 8, 2010
(February 7, 2010)
Can You Hear Me Up There? Giving Voice to Local Communities Imperative for Achieving Sustainability
Environmental & Energy Law & Policy Journal, Vol. 4, p. 256, 2009 Patricia Salkin Albany Law School Date Posted: February 8, 2010 Last Revised: February 8, 2010
(February 7, 2010)
Imagining the Unimaginable: Reducing U.S. Greenhouse Gas Emissions by Forty Percent
Virginia Environmental Law Journal, Vol. 26, pp. 271-290, 2008 David Hodas Widener University - School of Law Date Posted: February 8, 2010 Last Revised: February 8, 2010
(February 7, 2010)

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