LAW-2303 Medicare and Medicaid Law and Policy
Together, the federal Medicare and Medicaid program are the largest health insurance providers in America. Any attorney who intends to practice health care law must understand the operation of Medicare and Medicaid, and this course is designed to teach students the significant legal issues that arise in the operation of these programs. The first half of the course is devoted to legal issues that arise in the operation of the Medicare program, with special emphasis on the Medicare Modernization Act of 2003. It will also cover Medicare reimbursement issues; the structure of the Medicare program; procedural issues involved in challenging Medicare agency action; and, perhaps the most significant legal issue in Medicare today, the Medicare coverage process. The Medicare coverage process is of crucial importance to attorneys who practice in Massachusetts, given the prevalence of medical device and pharmaceutical/biological manufacturers in the state. The second half of the course is devoted to legal issues that arise in the operation of the Medicaid program. It, like the Medicare component of the course, will consider eligibility for Medicaid and the benefits available under the program. Students will also learn the legal and constitutional issues that arise in enforcing rights under the Medicaid program. The course will also discuss special topics in Medicaid, such as the requirements for coverage of prescription drugs under the Medicaid program, as well as Medicaid long-term care issues. Finally, the Medicaid section will also consider the financing issues that arise in this joint federal-state program. The course is taught by the most recent General Counsel of the U.S. Department of Health and Human Services in Washington, D.C. [367] Course updated: March 14, 2016