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.
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 Lawyer, Law.Com, National Law Journal, and New York Law Journal, as well as Lawyers Weekly.
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: 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 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.
[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 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 Earth Sciences - Environmental Science and Engineering subject cluster.
Aggregate Databases and Other Web Resources
Association of State and Territorial Health Officials
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