Policy Practicum: Advising Congress on Health Policy


Course Code:
LAW 413L
Law Honors/Pass/Restrd Cr/Fail


This policy lab will conduct research on national health policy problems for the Medicare Payment Advisory Commission, or MedPAC (MedPAC is an independent Congressional agency established by the Balanced Budget Act of 1997 to advise the U.S. Congress on issues affecting the Medicare program). Students will work in teams with lawyers and PhD economists from MedPAC, resident and fellow physicians from Stanford Hospital, and other students from throughout the University on one of two topics:nExpanding the healthcare workforce through reform of states' scope of practice regulation. This project will examine how changes in licensing rules governing health care providers' allowed scope of practice can accommodate the expansion of demand for health services due to the Affordable Care Act and other factors. Specific questions include: 1) Under existing state law, what additional tasks can non-physicians such as nurse practitioners, physician assistants, and pharmacists undertake that would reduce cost and/or improve quality? 2) What changes to state law might expand the allowed scope of practice of non-physicians that would reduce cost and/or improve quality? 3) What incentives might the federal government provide, either through Medicare or other means, to encourage states to reform optimally their scope of practice rules to reflect new available technologies?nDesigning antitrust policy to achieve the benefits of coordination and avoid the costs of consolidation. On one hand, closer links between physicians, hospitals, and other health care providers has the potential to reduce cost and improve quality by improving communication across care settings, avoiding wasteful duplication of effort, and reducing medical errors. On the other hand, consolidation may be used to exploit consumers by facilitating the exercise of health care providers' market power. This tension has become especially important due to incentives in the Affordable Care Act that encourage doctors and hospitals to join together in Accountable Care Organizations. This project will examine the following questions: 1) How can the U.S. Department of Justice and Federal Trade Commission use existing federal antitrust law to allow welfare-improving coordination while prohibiting welfare-reducing consolidation in ways that minimize costs of enforcement, including the legal uncertainty facing providers? 2) Can adoption of health-care-specific antitrust laws, such as those proposed or enacted in Massachusetts and California, effectively fill in the gaps in existing federal antitrust laws? 3) What incentives might the federal government provide, through design of reimbursement policies in the Medicare program, to complement federal and state antitrust laws?nConsent Application: To apply for this course, students must complete and e-mail the Consent Application Form available on the SLS Registrar's Office website (see Registration and Selection of Classes for Stanford Law Students) to the instructors. See Consent Application Form for submission deadline. Elements used in grading: Written Assignments, Final Paper. This course is cross-listed with HRP 222A and B.

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