Health Care Enforcement Research Articles

Order Keepers or Immigration Agents? Latine Immigrant Views of Law Enforcement in Healthcare Settings.

Police and security presence in healthcare settings have grown. There are few studies exploring perceptions of these law enforcement agents among US Latine immigrants, who can be vulnerable to immigration enforcement actions due to past and ongoing criminalization and anti-immigrant policies. To explore Latine immigrants' perceptions of law enforcement in healthcare settings. Exploratory, semi-structured qualitative interviews asked participants about their perspectives of law enforcement in healthcare settings. English- and Spanish-speaking adult patients (n = 19) from a Federally Qualified Health Center (FQHC) in Los Angeles, CA, serving predominantly low-income Latine immigrants. We used the framework method for analysis to establish a codebook and inform our thematic interpretation. We identified three themes: (1) perceptions of safety offered by police officers are separated from the role of immigration officers; (2) perceptions of police officers are integrated into broader perceptions of the healthcare system; and (3) lived experiences, including immigration status, influenced valence response to officer uniforms and perceptions of officers. Most participants viewed police officers positively as maintaining order and safety, separating them from federal immigration enforcement actions, and reflecting on local, state, and organizational "sanctuary" or immigrant-friendly policies. Individuals with precarious immigration status more often saw officers as intimidating. Immigration enforcement remained a key concern. Differentiating police and security roles from immigration enforcement in healthcare could improve Latine immigrant trust and access. Future studies should explore perspectives of Latine immigrants in localities without sanctuary laws or organizational immigrant-friendly policies.

Healthcare Enforcement Laws and Federal Healthcare Employment Laws: What Would Physicians be Prudent to Learn?

It is incumbent upon physicians to become knowledgeable regarding healthcare enforcement and employment laws. Federal regulatory policies directly impact how physicians practice medicine, and transgression of these laws can lead to loss of license, exclusion from CMS payments, fines, and civil and criminal penalties. Contravention of federal employment laws can result in similar devastating penalties. This article aims to equip the reader with a preliminary understanding of these complex laws. The interested reader will need to take a deeper dive into the weeds of healthcare enforcement and employment law.

Deterrence effects of antifraud and abuse enforcement in health care

Estimates of the benefits of antifraud enforcement in health care typically focus on direct monetary damages. Deterrence effects are acknowledged but unquantified. We evaluate the impact of a Department of Justice investigation of hospitals accused of billing Medicare for unnecessary implantable cardiac defibrillator (ICD) procedures on their use. Using 100 % inpatient and outpatient procedure data from Florida, we estimate that the investigation caused a 22 % decline in ICD implantations. The present value of savings nationally over a 10 year period is $2.7 billion, nearly 10 times larger than the $280 million in settlements the Department of Justice recovered from hospitals. The investigation had a large and long-lasting effect on physician behavior, indicating the utility of antifraud enforcement as a tool for reducing wasteful medical care.

Deterrence Effects of Antifraud and Abuse Enforcement in Health Care

Estimates of the benefits of antifraud enforcement in health care typically focus on direct monetary damages. Deterrence effects are acknowledged but unquantified. We evaluate the impact of a Department of Justice investigation of hospitals accused of billing Medicare for unnecessary implantable cardiac defibrillator (ICD) procedures on their use. Using 100% inpatient and outpatient procedure data from Florida, we estimate that the investigation caused a 22% decline in unnecessary ICD implantations. The present value of savings nationally over a 10 year period is $2.7 billion, nearly 10 times larger than the $280 million in settlements the Department of Justice recovered from hospitals. The investigation had a large and long-lasting effect on physician behavior, indicating the utility of antifraud enforcement as a tool for reducing wasteful medical care. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

Promoting Competition in Healthcare Enforcement and Policy: Framing an Active Competition Agenda

Promoting Competition in Healthcare Enforcement and Policy: Framing an Active Competition Agenda

Promoting Competition in Healthcare Enforcement and Policy: Framing an Active Competition Agenda

Promoting Competition in Healthcare Enforcement and Policy: Framing an Active Competition Agenda

Addressing Equity in Health Care at the Public-Private Intersection: The Role of Health Rights Enforcement in Hungary

This paper examines the role of the rights-based review in addressing inequities in access to health care. Focusing on the case of Hungary, the analysis intends to contribute to the debate about factors that bring about/sustain inequalities in health and health care at the public-private intersection and the role of law and rights-based litigation in addressing these inequalities. Towards this end, the paper presents first an overview of the Hungarian health care system. It then analyzes the scope and content of the right to health by discussing the constitutional protection of health rights and the right to health care guaranteed within the public health system. Further to that, the paper reviews the main mechanisms of rights enforcement in health care. It describes the health care litigation that has taken place in Hungary with focus on equity issues at the public-private intersection. The analysis is concluded by a discussion of the role of health rights enforcement in promoting equity in access to health care. The paper is a chapter of a book titled ''The Right to Health at the Public/Private Divide: A Global Comparative Study'', edited by Prof. Aeyal Gross and Prof. Colleen Flood, forthcoming by Cambridge University Press.

Physician collective bargaining.

Current antitrust enforcement policy unduly restricts physician collaboration, especially among small physician practices. Among other matters, current enforcement policy has hindered the ability of physicians to implement efficient healthcare delivery innovations, such as the acquisition and implementation of health information technology (HIT). Furthermore, the Federal Trade Commission and Department of Justice have unevenly enforced the antitrust laws, thereby fostering an increasingly severe imbalance in the healthcare market in which dominant health insurers enjoy the benefit of largely unfettered consolidation at the cost of both consumers and providers. This article traces the history of antitrust enforcement in healthcare, describe the current marketplace, and suggest the problems that must be addressed to restore balance to the healthcare market and help to ensure an innovative and efficient healthcare system capable of meeting the demands of the 21st century. Specifically, the writer explains how innovative physician collaborations have been improperly stifled by the policies of the federal antitrust enforcement agencies, and recommend that these policies be relaxed to permit physicians more latitude to bargain collectively with health insurers in conjunction with procompetitive clinical integration efforts. The article also explains how the unbridled consolidation of the health insurance industry has resulted in higher premiums to consumers and lower compensation to physicians, and recommends that further consolidation be prohibited. Finally, the writer discusses how health insurers with market power are improperly undermining the physician-patient relationship, and recommend federal antitrust enforcement agencies take appropriate steps to protect patients and their physicians from this anticompetitive conduct. The article also suggests such steps will require changes in three areas: (1) health insurers must be prohibited from engaging in anticompetitive activity; (2) the continuing improper consolidation of the health insurance industry must be curtailed; and (3) the physician community must be permitted to undertake the collaborative activity necessary for the establishment of a transparent, coordinated, and efficient delivery system.

The Historical Trajectory of Civil Rights Enforcement in Health Care

Since the late 1960s, federal civil rights enforcement initiatives in health have been half-hearted and ineffective. The historical failure of the federal government to address the possible role of racial discrimination has taken place despite considerable evidence that, for a number of services, racial and ethnic minorities continue to receive inferior treatment to that accorded to whites. In many cases, these treatment differences remain even after controlling for socioeconomic and insurance statuses, and standard covariates such as patient age, health status, and gender.

Antitrust enforcement in health care. Ten years after the AMA suit.

It has been almost a decade since the Federal Trade Commission (FTC) filed an antitrust suit against the American Medical Association (AMA) that successfully challenged a number of anticompetitive ...