Basic HTML Version
Medicare and Medicaid Law and Policy
Mr. Thomas R. Barker,
2 credits day; 2 credits evening.
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.
Elective Course
Meets Health/Biomedical Concentration Requirements
Final Paper Required