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Medicare and Medicaid Law Resource Guide

This selective guide highlights major print and electronic resources available to Cleveland-Marshall College of Law students researching issues in Medicare and Medicaid law.  Please contact the research services staff during research services hours, or via email to research.services@law.csuohio.edu, for help in locating these or other resources to meet your needs.


Some of the links below lead to CALI, LexisNexis, and Westlaw files, which require a student password for access.  [If you connect to any of these files, be sure to log out of the system at the end of your research.]  Other links lead to records in SCHOLAR, the Cleveland State University electronic catalog.  Use your browser's "Back" button to return to this Health Law Resource Guide.

Introduction

Cases

Statutes and Codes

Regulations and Rules

Treatises and Practice Guides

Study Aids

Searching SCHOLAR and OhioLINK

Journal Articles and Current Awareness Services

Aggregate Databases and Other Web Resources

 

Introduction

Medicare and Medicaid law concerns the federal government's health insurance program for elderly and disabled persons and persons with end-stage renal disease, as well as the federal and state governments' health insurance programs for persons receiving public assistance.  Topics include government health care appropriations; government trust funds; government payroll taxes; health care cost measurement and cost-effectiveness; health care insurance; health care networks; inpatient hospital, skilled nursing facility, home health agency, home health aide, hospice care, and other medical services coverage and payments; as well as prescription drug and biologicals coverage and payments.

Medicare and Medicaid law research provides particularly rich opportunities for understanding legislative and administrative law.  One of the primary duties of the state is to preserve public health.  Federal health law is concentrated on the U.S. Department of Health and Human Services, which administers numerous agencies and programs such as the Centers for Medicare & Medicaid Services.  Each state has the authority to establish its Medicaid eligibility standards, medical services coverage and payments, and administration.  States administer their Medicaid authority through agencies such as the Ohio Department of Job and Family Services.

Current health/medical knowledge is primarily found in the journal literature, and one should never simply rely upon books.  When searching the health/medical journal literature, note that, in addition to supporting keyword searching, health/medical indexing and abstracting services tend to use thesauri or controlled vocabulary.  This means human beings are involved in the indexing and abstracting of health/medical journal literature, resulting in extremely detailed and precise databases.  MeSH (Medical Subject Headings) is the thesaurus used by the U.S. National Library of Medicine in its MEDLARS (Medical Literature Analysis and Retrieval System) databases.  MEDLARS has over 40 databases, including Medline/PubMed.  Use MeSH when constructing search statements to take full advantage of the high quality comprehensive indexing supporting the MEDLARS databases.

In general, health/medical indexing and abstracting services do not provide full-text documents.  However, many provide links to full-text document services, and many journals are now available electronically.  See the Journal Articles and Current Awareness Services section below for additional information on print and electronic indexes, as well as electronic full-text journals.

If you're a student who's trying to pick a topic in Medicare and Medicaid law for a note or article, check out Lawtopic.com and review its Health Law section.  Also, consider reviewing current issues and hot topics on news Web sites such as American Lawyer Media's American LawyerLaw.Com, National Law Journal, and New York Law Journal, as well as Lawyers Weekly.

 

Cases

LexisNexis:  Area of Law - By Topic:  Medical:  Cases:  Federal and States Cases - Selected Healthcare Related Material  and  Insurance:  Cases:  Insurance, Federal and State Insurance Cases.  Include US Supreme Court, US Court of Appeals, Federal District Courts, all 50 States, District of Columbia, Puerto Rico, Virgin Islands, and other US territories as well as specialty courts such as Military Appeals, Customs, Patents, Tax, Trade, Commerce, Veteran Appeals, and Bankruptcy.  See also LexisNexis:  Area of Law - By Topic:  Medical:   Multi-Source Groups:  Healthcare Related Cases From All State Courts and ALR Annotations  and  Insurance:  Multi-Source Groups:  States and ALR Annotation Insurance Cases, All.

LexisNexis:  States Legal - U.S.:  Ohio:  Cases:  By Area of Law:  OH Health Cases  and   OH Insurance Cases.  Selected cases decided by the Ohio Supreme Court since 1821, Ohio Court of Appeals since 1913, and various Ohio Miscellaneous Courts since 1922.

Westlaw:  U.S. State Materials:  Case Law:  Multistate Cases Organized by Area of Practice:  Health & Medicine (MHTH-CS) and Insurance (MIN-CS).  Include all 50 states and the District of Columbia.  See also individual databases in Federal Cases section of Westlaw:  Topical Materials by Area of Practice:  Health & Medicine and Insurance.  See also Health and Insurance sections of Westlaw:  KeySearch.

Westlaw:  U.S. State Materials:  Ohio:  Cases:  Case Law Organized by Practice Area or Topic:  Health & Medicine (OHHTH-CS) and Insurance (OHIN-CS) .  Selected cases decided by the Ohio Supreme Court since 1821, Ohio Court of Appeals since 1913, and various Ohio Miscellaneous Courts since 1889.

 

Statutes and Codes

US Code:  Public Health and Welfare 42 USC; Medicare Program 42 USC §1395 et seq.Hospitals and Asylums 24 USCFood and Drugs 21 USC  [Links via Cornell Law School's Legal Information Institute; "generated from the most recent version made available by the US House of Representatives."]

Ohio Code:  Medical Assistance Programs ORC §5111 et seq.;  Health-Safety-Morals 37 ORCInsurance 39 ORC.  [Links via Anderson's and State of Ohio.]

 

Regulations and Rules

Code of Federal Regulations:  Public Health (Department of Health and Human Services)  42 CFR; Centers for Medicare & Medicaid Services, Department of Health and Human Services 42 CFR Chapter IV; Food and Drugs (Food and Drug Administration) 21 CFR Chapter 1.  [Links via GPO Access.]

Ohio Administrative Code:  Department of Job and Family Services - Division of Medical Assistance OAC 5101:3-1-01 et seq.; Department of Health OAC 3701 et seq.State Certificate of Need Review Board OAC 3702 et seq.; Statewide Health Coordinating Council OAC 3703 et seq.Commission on Minority Health OAC 3704 et seq.; Department of Insurance OAC 3901 et seq.  [Links via Anderson's and State of Ohio.]

 

Treatises and Practice Guides


Selected significant treatises and practice guides in the Cleveland-Marshall College of Law Library collection which provide a foundation in issues of Medicare and Medicaid law include the following:

CMS Congressional Guide: Medicare, Medicaid, SCHIP.  Centers for Medicare and Medicaid Services, 2004.  RA412.3 .C46 2004

Elder Law and the Deficit Reduction Act of 2005: with Analysis by the LexisNexis Elder Law Editorial Board / David M. English, Rebecca C. Morgan, and Stuart D. Zimring.   LexisNexis, c2006.   KF3737 .E54 2006

False Alarm: Why the Greatest Threat to Social Security and Medicare Is the Campaign to "Save" Them / Joseph White.  Johns Hopkins University Press, c2001.   HD7125 .W473 2001

Guide to Medicare Coverage Decision-Making and Appeals / Eleanor D. Kinney, ed.   American Bar Association, c2002.   KF3608 .A4 G85 2002

The Law of Later-Life Health Care and Decision Making / Lawrence A. Frolik. American Bar Association, c2006.   KF3608 .A4 F76 2006

Legal Aspects of Health Care Reimbursement / Robert J. Buchanan and James D. Minor.   BeardBooks, c2001.   KF3605 .B82 2001

Medicare and Medicaid Claims and Procedures / Harvey L. McCormick.  Thomson/West, c2005.   KF3605 .M3 2005

Medicare Prescription Drug, Improvement, and Modernization Act of 2003: Law and Explanation.  CCH Inc., c2004.   RA412.3 .M434 2004

The Political Economy of Health Care Reforms / Huizhong Zhou, ed.  Upjohn Institute for Employment Research, c2001.   RA395 .A3 P625 2001

The Political Life of Medicare / Jonathan Oberlander.  University of Chicago Press, c2003.   RA412.3 .O24 2003

Reference Guide for Medicare Physician & Supplier Billers: Helping Front Office Personnel Navigate Medicare Rules for Part B Claims Processing.  Department of Health & Human Services, Centers for Medicare & Medicaid Services, Medicare Learning Network, 2004.   RA412.3 .R445 2004 & Electronic

Social Security and the Middle-Class Squeeze: Fact and Fiction about America's Entitlement Programs / Leonard J. Santow and Mark E. Santow; forward by Henry Kaufman.   Praeger Publishers, c2005.   HD7125 .S26 2005

Who Should Pay for Medicare? / Daniel Shaviro.  University of Chicago Press, c2004.   RA412.3 .S53 2004

 

Estate, Financial and Health Care Planning for Elder Clients in Ohio / William J. Browning ... et al.  NBI, c2001.   KFO140 .E8 2001

Medicaid Planning Satellite.  Ohio State Bar Association CLE Institute, c2005.   KFO91 .A3 M32 2005

 

Study Aids

Health Care Law and Ethics In a Nutshell / Mark A. Hall, Ira Mark Ellman, and Daniel S. Strouse.  West Group, c1999.   KF3821 .Z9 H35 1999

 

Searching SCHOLAR and OhioLINK   (SCHOLAR hands-on instruction)

SCHOLAR is the electronic catalog for Cleveland State University's Law Library and University Library.  CSU also participates in the state-wide consortia OhioLINK, which provides access to a state-wide central catalog and numerous research databases.  For treatises and other materials, search the SCHOLAR and OhioLINK catalogs with the subject headings Medicare and Medicaid.  See also the Medicare Related Subject Headings and Medicaid Related Subject Headings.

 

Journal Articles and Current Awareness Services

See the Finding Articles in Law Reviews, Journals and Other Legal Periodicals guide for an explanation of the legal periodical indexes and databases available to Cleveland-Marshall College of Law students and the CSU community.  That guide covers print and electronic indexes, as well as electronic full-text journals.  In particular, note OhioLINK's Electronic Journal Center and its Health Sciences and Medicine subject cluster.

 

Aggregate Databases and Other Web Resources

Association of State and Territorial Health Officials

Medicare.gov

National Academy for State Health Policy

National Health Information Center

Ohio Department of Insurance:  Consumer Services:  Services for People on Medicare (Ohio Senior Health Insurance Information Program - OSHIIP)

Ohio Department of Job & Family Services:  Health Care

U.S. Department of Health and Human Services:  Centers for Medicare and Medicaid Services

 

Cornell Law School's Legal Information Institute:  Law about:  Medicare  and  Medicaid

FindLaw:  Practice Areas:  Health Law

Jurist:  Legal Research:  Law Guides:  Health Law

LexisONE:  Legal Web Site Directory:  Practice Areas:  Healthcare Law

LexisNexis:   Area of Law - By Topic:  Medical

Includes federal and state cases, court rules, statutes and legislative materials, administrative materials and regulations, law reviews and journals, treatises and analytical materials, CLE course listings and information, legal news, legal reference materials, medical journals, medical news and information, medical references (including Medline), and compliance materials.

LexisNexis:  Area of Law - By Topic:  Insurance

Includes federal and state cases; court records; briefs, motions, pleadings and verdicts; statutes and legislative materials; administrative materials and regulations; law reviews and journals; treatises and analytical materials; general news; insurance compliance materials; legal news; legal reference materials; company and financial information; insurance policy forms; state departments of insurance materials; Sarbanes-Oxley Corporate Reform materials; and jury verdicts.

MedWorld:  MedBot:  Super Search

Chose up to four databases to search at the same time from Web search engines, general and medical indices, as well as medical education, news, and multimedia sites.

OhioLINK Research Databases:  Medicine and Health

Includes CHID Online (Combined Health Information Database; produced by US government health-related agencies), Clinical Medicine and Health Research (articles not yet published, and may not yet be peer reviewed), Clinical Pharmacology (drug monographs for US prescription drugs, over-the-counter products, herbal and nutritional products, as well as new and investigational drugs), Medline, OT Search (occupational therapy), CINAHL (nursing and allied health), Institute for Scientific Information Citation Databases (particularly Science Citation Index and Social Sciences Citation Index), Papers First, and Proceedings First.

OhioLINK Research Databases:  Law and Legislation

Includes Congressional Universe (particularly "Hot Bills/Topics" group), Index to Legal Periodicals and Books, LexisNexis Congressional (same as Congressional Universe), LexisNexis Academic (particularly "News" and "Medical" groups), Papers First, and Proceedings First.

Rominger Legal:  Practice Areas:  Health Care

Includes statutes and codes, news, professional directories, links to health care organizations and HMOs, subject specific links, as well as links to administrative agencies, bureaus, and commissions.

Westlaw:  Topical Materials by Area of Practice:  Health & Medicine
Includes federal and state cases, federal and state statutes, federal and state administrative materials, litigation reports, daily reports & current developments, periodicals, treatises, practice materials, medical research materials (including Medline), news, and reference materials.

Westlaw:  Topical Materials by Area of Practice:  Insurance

Includes federal and state cases, federal and state court rules and orders, pleadings, briefs, federal and state statutes, federal and state administrative materials, state insurance bulletins, National Association of Insurance Commissioners materials, law reviews, legal texts & periodicals, news, forms, CLE & practice materials, and jury verdicts.

 

American Medical Association:  AMA Agenda:  Advocacy Efforts:  Medicare Reform

The Century Foundation:  Health Policy Watch

Emory University's MedWeb:  Health Care:  Medicare  and  Medicaid

MedExplorer:  Medicare  and  Medicaid

Senior Law:  Medicare and Medicaid Updates

Telemedicine Information Exchange

 

 

Laura E. Ray, MA, MLS

Educational Programming Librarian

September 2006

 

 

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