Journal of health law
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Journal of health law · Jan 2005
Will EMTALA changes leave emergency patients dying on the hospital doorstep?
Despite charges that it is at times ambiguous and overly burdensome, the Emergency Medical Treatment and Labor Act (EMTALA) remains an important protection for patients, and a valuable instrument for enforcing public policy goals in the area of emergency healthcare services. The 250 Yard Rule is a small but crucial part of EMTALA, extending the statute's protections to emergency patients who have narrowly failed to reach the hospital's entrance. ⋯ This Article explores the legal and public policy origins of the 250 Yard Rule and their continuing applicability in the current regulatory environment. The Article concludes that the regulatory basis for the 250 Yard Rule remains intact and that the legislative intent behind EMTALA, as well as ongoing public policy goals, dictate that the 250 Yard Rule be preserved.
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Journal of health law · Jan 2005
Understanding the physician-owned specialty hospital phenomenon: the confluence of DRG payment methodology and physician self-referral laws.
Physician-owned specialty hospitals have flourished in today's healthcare arena, but also have been the subject of a great deal of controversy. The author argues that the rise of specialty hospitals has been the result of a confluence of two healthcare policies: (1) skewed DRG payment methodologies and (2) the misapplication of exemptions to the Stark Law's ban on physician self-referral. This Article examines the aspects of these healthcare policies that have allowed for the explosion of specialty hospitals, as well as the arguments for and against the creation and need for specialty hospitals. The Article also analyzes the reform proposals to correct the Stark and DRG methodologies and how those proposals will affect both specialty and general hospitals.
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"Sponsored research," wherein a business corporation or the government pays a portion of the cost of research activities carried out by a university or hospital, is increasingly important both for state institutions and for Section 510(c)(3) organizations. Sponsored research arrangements that are not properly structured can jeopardize the status of tax-exempt bonds issued to finance the facility at which the sponsored research occurs. While these rules have been difficult to apply in practice, properly structured agreements can provide funding for research without undue risk. This Article discusses the multiple pieces of guidance put forth by the Internal Revenue Service to clarify the many issues and tiers of analysis necessary to ensure a properly-structured sponsored research agreement.
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Journal of health law · Jan 2003
The disutility of advance directives: we know the problems, but are there solutions?
Advance directives (ADs) are recognized in some form by the laws of every state. Despite the availability of ADs for more than twenty years, few adults have completed any type of AD document. ⋯ The failure to honor an AD may stem from the physician's belief that to honor a directive would not be in the patient's best interest. The adoption and enforcement by all states of the Uniform Health-Care Decisions Act, recognition of a physician's ethical duty to assist patients in AD formulation, and routine third-party payor reimbursement to physicians for their role in patients' advance care planning will encourage and facilitate the completion and subsequent honoring of patients' directives.