Medicare and Medicaid 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.
Please contact the Law Library's Research Services librarians during their Research Services hours, or via email for help with locating or using any of the resources discussed in this guide.
Cases
LexisNexis: Area of Law - By Topic: Medical: Find Cases: Federal and States Cases - Selected Healthcare Related Material -- and -- LexisNexis: Area of Law - By Topic:
Insurance: Find 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.
LexisNexis: States Legal - U.S.: Ohio: Find 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.
Westlaw: Topical Materials by Area of Practice: Health & Medicine: Federal Cases.
Westlaw: Topical Materials by Area of Practice:
Insurance: Federal Cases.
Westlaw: KeySearch: Health and Insurance sections.
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 USC; Food 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 ORC; Insurance 39 ORC.
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.; Commission on Minority Health OAC 3704 et seq.; Department of Insurance OAC 3901 et seq.
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
Facilitating Access to Medicare Part D Drug Claims Data / Elizabeth Hargrave and Jack Hoadley. MedPAC, c2008. Electronic
The Law of Later-Life Health Care and Decision Making / Lawrence A. Frolik. American Bar Association, c2006. KF3608 .A4 F76 2006
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 Life of Medicare / Jonathan Oberlander. University of Chicago Press, c2003. RA412.3 .O24 2003
A Practical Guide to Medicare Appeals / Kathleen Scully-Hayes and Daniel A. Cody. ABA Pub., c2007. KF3608 .A4 S38 2007
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
Health Care Law. Ohio State Bar Association CLE, c2007. KFO360 .H435 2007
Medicaid and Medicare. Ohio State Bar Association CLE, c2008. KFO341.5 .P65 M42 2008
Medicaid Planning Satellite. Ohio State Bar Association CLE Institute, c2005. KFO91 .A3 M32 2005
Medicaid, SNTs and Pensions: and Medicare. Ohio State Bar Association CLE, c2007. KFO341.5 .P65 M43 2007
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 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
CCH Health and Human Resources - Health Care Reimbursement
CCH Health and Human Resources - Health Care Compliance
American Medical Association: Current Topics in Advocacy
Association of State and Territorial Health Officials
The Century Foundation: Health Policy Watch
Cornell Law School's Legal Information Institute: Law about: Medicare and Medicaid
FindLaw For Legal Professionals Under "Research the Law" tab - Primary Materials, note Practice Areas. From here can connect to 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.
MedExplorer: Medicare and Medicaid
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.
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
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), several Medline databases, OT Search (occupational therapy;
includes coverage of health care delivery or administration), CINAHL (nursing and allied health sciences), Health Source: Nursing/Academic Edition (includes Clinical Pharmacology, which provides drug monographs for US prescription drugs, over-the-counter products, herbal and nutritional supplements, as well as new drugs)
, Institute for Scientific Information Citation Databases (particularly Science Citation Index and Social Sciences Citation Index), Papers First, Proceedings First, and PsycINFO.
OhioLINK Research Databases: Law and Legislation
Includes 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.
Senior Law: Medicare and Medicaid Updates
Telemedicine Information Exchange
U.S. DHHS Centers for Medicare and Medicaid Services
U.S. DHHS Medicare.gov
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.
LER
September 2008
links checked 8/6/2009