Health Insurance Reform
SLN #: 13374Course Prefix: LAW-791
Course Section: 021
Credit Hours: 3
Instructor(s): Michaels
Course Books: View List of Books
Course Description:
The course will focus on the law surrounding three key principles of health insurance reform: (1) providing expanded access to health care coverage through private insurance plans in both the commercial and government subsidized markets; (2) the need of health insurers to change provider payment systems that impact health care costs and quality outcomes; and (3) the challenges associated with greater consumer engagement in the health insurance marketplace through the design and pricing of health benefit plans, as well as increased consumer understanding of health care costs and quality outcomes. The objective of the course is to examine the legal interplay of the three principles referenced above in the health insurance market context. These components will need to be aligned if meaningful health insurance reform is to occur in the United States under the current health care financing system.
The course will analyze the commercial health insurance markets with a particular focus on the impact of the Affordable Care Act on the stability of these markets, as well as any changes that are made to the legislation in its design or implementation, or as a result of judicial determinations. The use of private insurers to provide coverage to Medicare beneficiaries, including the Medicare Advantage Part C and Medicare Part D Programs, will also be reviewed and analyzed, along with managed care plans engaged by State Medicaid Programs (including Arizona’s Medicaid Program), to provide coverage to lower income populations. In addition, the impact of prescription drug prices on health insurance premiums will also be addressed, including efforts by health insurers to manage these costs, and state and federal law initiatives that attempt to control prescription drug prices.
Evolving changes in provider payment systems utilized by health insurers will be assessed to identify the dramatic shift away from the traditional fee-for-service model to payment innovations focused on quality outcomes and cost efficiencies. How will these new changes affect the legal environment which was initially based on a fee-for-service system?
Finally, the role of the insured as a consumer of health care services will be explored. This will include the issues of financial engagement and wellness, and the information consumers need to have about provider networks, health care costs, and quality outcomes to ensure the competitiveness of the health insurance marketplace.
Additional Information:
Credit Hours: 3
Grading Option: Letter Grade Only
Graduation Writing Requirement: No
Flexible/Upper-Level Writing Requirement: Yes
Skills Requirement: No
Simulation Course: No
Experiential Learning: No
Seminar: No
Prerequisite: It is recommended that students have taken a more general health law survey course or health law and policy course before enrolling in this course.
Special Withdrawal Course: No
Limited Enrollment Number: 15
Final Exam Given: No
Paper Or In-Class Presentation: Yes, Paper
Attendance Policy: Per Statement Of Student Policies
* The law school has a policy that is used to calculate credit hours. Please see the Statement of Student Policies.