The ethical health lawyer

Journal of Law, Medicine and Ethics

Volumn 35, Issue 2, 2007, Pages 320-324

  Weeks, Elizabeth A ^a  

^a UNIVERSITY OF KANSAS   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; DIAGNOSIS RELATED GROUP; ECONOMICS; ETHICS; HUMAN; JURISPRUDENCE; LEGAL ASPECT; LEGAL LIABILITY; MEDICARE; SOCIAL BEHAVIOR; UNITED STATES;

HUMANS; JURISPRUDENCE; LIABILITY, LEGAL; MEDICARE; OUTLIERS, DRG; SOCIAL RESPONSIBILITY; UNITED STATES;

EID: 34248994547     PISSN: 10731105     EISSN: 1748720X     Source Type: Journal    
DOI: 10.1111/j.1748-720X.2007.00142.x     Document Type: Article

References (28)

1. A. Smith, The Wealth of Nations, E Cannan, ed. (New York : The Modern Library, 2000 book IV, chapter II, at 484 85.
2. H. G. Manne Milton Friedman Was Right Wall Street Journal, November 24, 2006, at A12.
3. See D. C. Langevoort Resetting the Corporate Thermostat: Lessons from the Recent Financial Scandals about Self-Deception, Deceiving Others and the Design of Internal Controls Georgetown Law Journal 93, no. 1 (2004 285-317, at 288. ("[I]nvoking psychological traits makes the orthodox corporate scholars queasy for a variety of well-mooted reasons, including their contingent, soft, hard-to-model properties and the economists' natural suspicion that cognitive weaknesses are weeded out in the crucible of corporate competition and thus trivial.").
4. See G. Calabresi and P. Bobbitt, Tragic Choices (New York : W.W. Norton & Co. Inc. 1978 at 33 (describing pure market as presenting "the wrenching spectacle of a rich man and a poor man bidding against each other for life").
5. Sarbanes-Oxley Act of 2002, Pub. L. No. 107-204, 116 Stat. 745 (codified in scattered sections of 11, 15, 18, 28, and 29 U.S.C.); see generally L. E. Ribstein Market vs. Regulatory Responses to Corporate Fraud: A Critique of the Sarbanes-Oxley Act of 2002," Journal of Corporation Law 28, no. 1 (2002): 1-67; Note, "The Good, the Bad, and Their Corporate Codes of Ethics: Enron, Sarbanes-Oxley, and the Problems with Legislating Good Behavior Harvard Law Review 116, no. 7 (2003 2123 2141.
6. See Manne, supra note 2.
7. See R. E. Rosenblatt et al., Law and the American Health Care System (New York : Foundation Press, 1997 at 486-87 (quoting excerpt from G. Anders, "A Plan to Cut Back on Medicare Expenses Goes Awry; Costs Soar: Hospitals Rush to Remodel to Offer Subacute Care - And Get Paid Twice," Wall Street Journal, October 3, 1996, at A1).
8. Stephenson v. Shalala, 87 F.3d 350 (9th Cir. 1996) (included in Rosenblatt, supra note 7, at 487-94); see 42 U.S.C. § 1395cc(a)(2)(A)(ii) (1995) (beneficiary payment); 42 U.S.C. § 1395l(a)(2)(B)(i) (1995) (government payment).
9. See Langevoort, supra note 3, at 303 (suggesting that Machiavellian leaders are "adept at rationalization: convincing himself as well as others that what is self-serving is also right" andthat "[t]his sort of ethical plasticity...makes it much easier to win successive rounds over both the ethically stout and the ethically void").
10. E. A. Weeks Gauging the Cost of Loopholes: Health Care Pricing and Medicare Regulation in the Post-Enron Era Wake Forest Law Review 40, no. 4 (2005 1215 86.
11. See id., at notes 174-84 and accompanying text (citing Federal Register and other agency statements, acknowledging but declining to close outlier loophole).
12. Id., at 1253-55 (describing outlier initiative).
13. 42 U.S.C. § 1395ww(d)(5)(A) (2000); 42 C.F.R. § 412.84 (2000).
14. R. L. Rundle Tenet to Pay $725 Million to Settle Medicare Case Wall Street Journal, June 29, 2006, at A3; D. Kocieniewski, "Hospitals Grew with Medicare Paying the Way," New York Times, August 20, 2006, at 1, 23 (describing $265 settlement by non-profit Saint Barnabas Health Care System for "systematically inflating their bills").
15. K. Vogt Suit Claims Unnecessary Surgeries at Tenet American Medical News, May 19, 2003 (quoting opposing counsel's comment), available at http://www.ama-assn.org/amednews/2003/05/19/bisc0519.htm last visited March 15, 2007).
16. 42 U.S.C. § 1395 (Supp. IV 2000) (prohibiting government from "exercis[ing] any supervision or control over the administration or operation of any institution," which arguably includes billing practices).
17. D. Armstrong How Some Doctors Turn a $90 Profit from a $17 Test; Physician Groups Add Markup to Work Done by Others Despite Ethical Concerns; Administrative Costs Cited Wall Street Journal, September 30, 2005, at A1.
18. 42 C.F.R. § 424.80(b)(2) & (d) (2007) (setting forth contractual arrangement exception to Medicare ban on reassignment of supplier claims).
19. See Medicare Program, Revisions to Payment Policies, 71 Fed. Reg. 69624 December 1, 2006 declining to make changes to rule, but stating that issue would be studied and changes would be made "in the near future".
20. See 42 U.S.C. § 1395nn (Supp. IV. 2000).
21. See 42 U.S.C. § 1320a - 7b(b) (Supp. IV. 2000).
22. See 31 U.S.C. § 3729(a)(1) (Supp. IV. 2000).
23. See Armstrong, supra note 17, at A8.
24. J. Weil Nine Are Charged in KPMG Case on Tax Shelters Wall Street Journal, August 30, 2005, at C1.
25. Id., at C4.
26. The Massachusetts Plan and the Future of Universal Coverage, papers presented at the Kansas Law Review Annual Symposium, Lawrence, Kansas, November 10, 2006 (papers to be published in Kansas Law Review, no. 4 [2007]).
27. An Act Providing Access to Affordable, Quality, Accountable Health Care, 2006 Massachusetts Acts, Chapter 58, Section 47.
28. See Governor's Health Care Proposal http://gov.ca.gov/pdf/press/ Governors_HC_Proposal.pdf (last visited March 21, 2007); see also S. W. Arthurs Health Plan Brings Praise, Concerns Eureka Times-Standard (Eureka, CA), January 10, 2007, available at http://times-standard.com/local/ci_4983976 (last visited March 15, 2007); "Arnold's Health Plan to Stir Debate," Washington Times, January 10, 2007, available at http://washingtontimes.com/national/ 20070109-115721-9479r.htm last visited March 15, 2007).