Reviews in Medical Ethics: Medicare: Where is the Common Sense? A Review of Medicare Meets Mephistopheles by David A. Hyman

Hyman D. , Medicare Meets Mephistopheles (Washington, DC: The Cato Institute, 2006): at 27.

Id., at 31.

Id., at 41.

Id., at 45.

Id., at 50.

Id., at 53.

Id., at 57

Id., at 63.

Id., at 59.

Id., at 67.

Id., at 41.

The Medicare Prescription Drug Benefit and Modernization Act uses a means test for premiums under Part B, which pays for physician services. Medicare Prescription Drug Benefit and Modernization Act, Pub. L. 108–173 (2003). See also Hyman , supra note 1, at 17.

Mashaw J. and Marmor T. , “Understanding Social Insurance: Fairness, Afford-ability, And the ‘Modernization’ Of Social Security and Medicare” Health Affairs 25 (2006): W114–134 at w131.

Hyman , supra note 1, at 41.

Supra note 13.

Hyman , supra note 1, at 41. “This one-way ratchet has operated in all aspects of the Medicare program. As a group, the elderly received far more from the public trough than they ever paid in (and more than is economically sustainable) even before the MMA, which made things substantially worse for younger taxpayers.”

Hyman , supra note 1, cartoon at 58.

Hyman , supra note 1, at 16.

Hyman , supra note 1 at 89.

A monthly income of $712 is the cutoff for most states. Help Paying for Medicare, at <http://www.medicarerights.org/main-contentmedicarecosts.html> (last visited October 10, 2006).

In 1988, the Medicare Catastrophic Coverage Act was enacted, which created the Qualified Medicare Beneficiary (QMB) program. In 1990, the Specified Low-Income Medicare Beneficiary (SLMB) eligibility group was established. Key Milestones in CMS Programs, available at <http://www.cms.hhs.gov/History/Downloads/CMSProgramKeyMile-stones.pdf> (last visited October 10, 2006).

Supra note 23.

Barents Group LLC, A Profile of QMB-Eligible and SLMB-Eligible Medicare Beneficiaries, HCFA Report (prepared for the Health Care Financing Administration) (1999): at xiii.

Supra note 13.

Lamphere J. and Rosenbach M. , AARP Report, Bridging the Gaps Between Medicare and Medicaid: The Case of QMBs and SLMBs [Report prepared for the AARP's Research Group, Public Policy Institute] (Commerce Clearing House, Inc., 2006).

Wilson R. F. , Students Assisting Seniors' Year End Report, November 15, 2004 (reporting on the yearly progress of a program established at the University of South Carolina to assist low-income senior citizens to enroll in the QMB and SLMB programs).

Supra note 26, at xii.

Supra note 29.

Medicare and Medicaid Guide (Commerce Clearing House, Inc., 2006).

Medicare and Medicaid Guide 1 (Commerce Clearing House, Inc., 2006): at 6.

Id., at 3001.

Medicare and Medicaid Guide 6 (Commerce Clearing House, Inc., 2006): at 30, 527.

Hyman , supra note 1, at 35; U.S. v. Krizek, 11 F.3d 934 (D.C. Cir. 1997).

31 U.S.C.A. §3729(a) (2006).

Krizek , supra note 40, at 936.

Gosfield A. , Medicare and Medicaid Fraud and Abuse (Thompson/West, 2006): at 331.

Florida Attorney General's Office, “Message from Attorney General Charlie Crist,” at <http://myfloridalegal.com/NewsBrie.nsf/OnlineBriefs/7FC487B351EC11BF8525718F004A77B4> (last visited October 10, 2006).

Supra note 43.

Supra note 43.

Supra note 43.

“The Loneliest Losers,” Sports Illustrated, November 18, 2002.

SMU Football webpage, at <http://smu-mustangs.cstv.com/sports/m-footbl/smu-m-footbl-main.html> (last visited October 10, 2006).

Supra note 48.

“McLeod Regional Medical Center to Pay US Over $15 Million to Resolve False Claims Act Allegations,” November 1, 2002, Department of Justice website, available at <http://www.usdoj.gov/opa/pr/2002/November/02_civ_634.htm> (last visited October 10, 2006).

Hobbs J. M. , “So Much To Lose: Minor Problems Can Lead to Major Losses for any Health Care Professional,” The Legal Intelligencer, July 10, 2006.

Burnham S. , “Let's Repeal the Field Code!” Montana Law Review 67 (2006). “The English codifier Jeremy Bentham referred to the common law as ‘dog law,’ for a person trains a dog by punishing it for not following a rule, and thus teaches it what the rule is after the fact.”

LSU Law Center's Medical and Public Health Law Site, at <http://biotech.law.lsu.edu/cases/adlaw/AAMC_v_US_review.htm> (last visited October 10, 2006).

After the University of Pennsylvania settled, the American Association of Medical Colleges filed suit for declaratory and injunctive relief, based on the government's alleged retroactive application in the PATH investigations of a 1995 clarification to the law. The United States Court of Appeals for the Ninth Circuit noted that the government admitted the highly confusing nature of the regulation and that carriers had been providing guidance that was often erroneous to providers. Am. Ass'n. Of Med. Coll. v. U.S., 217 F.3d. 770 (9th. Cir. 2000) aff'd in part. Ultimately, the Ninth Circuit affirmed the lower court's dismissal for want of jurisdiction, but reversed the dismissal with prejudice, leaving the AAMC free to bring suit again later.

Chielli J. , “Teaching Hospital Audits Hit Region,” Physician's News Digest, May 1998, available at <http://www.physiciansnews.com/cover/598wp.html> (last visited October 10, 2006).

Id. Although the PATH audits finally concluded in 2005 with settlements in excess of $130 million, hospitals believe they are still vulnerable to similar audits given all the ambiguity of Medicare's rules and the economic penalties they may face if they do not settle. Health Sciences Compliance Newsletter, Spring 2005, USC Office of Compliance, available at <http://www.usc.edu/admin/compliance/pdfs/Health%20Sciences%20Compliance%20NewsletterSpring%202005.pdf#search=%22university%20of%20pittsburgh%20path%20settlements%22> (last visited October 10, 2006).