Associate Dean and Professor of Law, Bion M. Gregory Chair in Business Law
San Francisco, CA, UNITED STATES
Contacts: email@example.com / 415-581-8834 / Office 394-200
Ph.D., Health Policy, Concentration in Ethics
NBC News online
It's already becoming a controversy. “Since Roe v. Wade, people have assumed that women can have an abortion for any reason prior to viability, but the courts have never directly addressed the issue,” according to Jaime S. King, a professor of law at the University of California, Hastings. As she put it in a recent essay, “the question of whether a woman’s reason matters is upon us.”...view more
Law and Bioscences Workshop Stanford Law School, Stanford, CA
The New Health Care Industry: Integration, Consolidation, Competition in the Wake of the Affordable Care Act Yale Law School, New Haven, CT
Health Law Workshop Harvard Law School, Cambridge, MA
Expert Roundtable San Francisco Board of Supervisors, San Francisco, CA
Testimony before the Subcommittee on Regulatory Reform, Commercial and Antitrust Law Judiciary Committee of the U.S. House of Representatives, Washington, D.C.
The Grove Foundation
The Source provides up-to-date and easily accessible information about healthcare price and competition in the United States by posting news articles, policy papers, academic articles, litigation documents, and legislative/regulatory materials, as well as both legal and policy-based analysis of those materials and other relevant events. The Source aims not only to bridge the gaps between health policy, health services research, and legal experts working on issues surrounding healthcare costs and competition, but also seeks to serve as a resource for journalists, state attorneys general, potential litigants, and others seeking to understand and/or promote cost control and competition in healthcare. We launched the website June 5, 2014. The Source now also has an advisory committee of national experts and a presence on Twitter and Facebook. (2013-2020).view more
National Institutes of Health / UCSF
Direct legal research on the constitutional, statutory, and regulatory constraints on expanding existing newborn screening programs to include pharmacogenomics variants, and assist in the development of new policy recommendations. Collaborate with researchers from UCSF and the Hastings Center in New York to create a framework for determining the legal and ethical boundaries for mandatory and voluntary newborn genetic testing. The goal is for this framework to serve as a model for California and then expand into other states. (2013-2018).
Collaborated with researchers from UCSF and UC Hastings to examine the implications of improving price transparency on the overall cost of healthcare. Supervised two legal fellows in conducting research on the legal, economic, and systemic barriers to price transparency. Drafted a significant white paper outlining a range of legal and non-legal solutions to implementing price transparency initiatives in a manner that will reduce overall healthcare prices. (2012-2013).
Named as a Key Partner/Legal Consultant on a grant run by researchers at UCSF. The grant focused on community-based improvements on patient education for breast cancer patients. Analyzed the legal issues associated with patient privacy and use of these recordings for a variety of purposes (2011-2013).
State newborn screening (NBS) programs routinely screen nearly all of the 4 million newborns in the United States each year for ∼30 primary conditions and a number of secondary conditions. NBS could be on the cusp of an unprecedented expansion as a result of advances in whole-genome sequencing (WGS). As WGS becomes cheaper and easier and as our knowledge and understanding of human genetics expand, the question of whether WGS has a role to play in state NBS programs becomes increasingly relevant and complex. As geneticists and state public health officials begin to contemplate the technical and procedural details of whether WGS could benefit existing NBS programs, this is an opportune time to revisit the legal framework of state NBS programs. In this article, we examine the constitutional underpinnings of state-mandated NBS and explore the range of current state statutes and regulations that govern the programs. We consider the legal refinements that will be needed to keep state NBS programs within constitutional bounds, focusing on 2 areas of concern: consent procedures and the criteria used to select new conditions for NBS panels. We conclude by providing options for states to consider when contemplating the use of WGS for NBS.view more
Accountable Care Organizations (ACOs), originally developed as part of the Affordable Care Act (ACA), are growing—and serve both public and private sector payers. They have the potential to improve health care quality and patient outcomes while achieving cost savings. However, they may also present risks—including those related to solvency, consumer protection, and anti-competitive pricing—to providers, patients, and payers.
How can state policymakers respond to their development? What is in the public interest? What are the lessons from commercial health insurance and managed care regulatory frameworks? State policymakers are looking for evidence and experience to help them answer these and other questions.
A new report, “State Actions to Promote and Restrain Commercial Accountable Care Organizations,” written by researchers at the Nicholas C. Petris Center on Health Care Markets and Consumer Welfare, School of Public Health, University of California, Berkeley, draws on evidence from the literature and four case studies to outline tools that state governments can use to promote the potential benefits of ACOs while mitigating their potential risks. The Milbank Memorial Fund provided support for this report by assisting with its review and dissemination.
As healthcare expenditures continue to climb, politicians, business leaders, and patients avidly search for new methods to reduce healthcare costs. In an eleven-point plan released this summer, a group of the nation’s top healthcare experts listed “full transparency of prices” as one potential solution to reduce healthcare costs. The experts, some of whom helped write the Patient Protection and Affordable Care Act, argued that price transparency would allow consumers to compare prices before choosing a provider or hospital and, consequently, better anticipate their overall costs. In turn, they argued that making price information publicly accessible would also reduce excess healthcare spending by encouraging providers to offer more competitive pricing. Other health services research, however, suggests that legislative and regulatory efforts to promote price transparency may result in increased healthcare costs depending on the market conditions and the various stakeholders targeted. Consequently, any price transparency initiative must not only make prices transparent, but also account for the differences between markets, either by reducing the economic inefficiencies that keep price transparency from being effective or by targeting only the specific regions where the market would support such an initiative. This article analyzes whether price transparency initiatives can be effectively used to reduce healthcare costs, and if so, what conditions must be met for them to do so. The features of a well-designed price transparency initiative will vary depending upon the targeted population (patients, employers, providers, or insurers) and the particular features of the target market. We argue that the most effective solutions will mandate disclosure of price and quality information at the appropriate stakeholder levels and, simultaneously, break down provider market leverage where it prevents price transparency from helping consumers. Together, these two elements have the potential to lower healthcare costs. Finally, we present four possible price transparency initiatives that represent a range of possible avenues to promoting effective price transparency including litigation, legislation, regulation, and consumer driven initiatives.view more
To provide an ethical framework for clinicians and companies providing non-invasive prenatal testing using cell-free fetal DNA or whole fetal cells.
In collaboration with an NIH-supported research ethics consultation committee, together with feedback from an inter-disciplinary group of clinicians, members of industry, legal experts and genetic counselors we developed a set of best practices for the provision of non-invasive prenatal genetic testing.
Principal recommendations include the amendment of current informed consent procedures to include attention to the non-invasive nature of new testing and the potential for a broader range of results earlier in the pregnancy. We strongly recommend that tests should only be provided through licensed medical providers and not direct-to-consumer.
Prenatal tests, including new methods using cell-free fetal DNA, are not currently regulated by government agencies and limited professional guidance is available. In the absence of regulation, companies and clinicians should cooperate to adopt responsible best ethical practices in the provision of these tests.
In 2007 Washington State became the first state to enact legislation encouraging the use of shared decision making and decision aids to address deficiencies in the informed-consent process. Group Health volunteered to fulfill a legislated mandate to study the costs and benefits of integrating these shared decision-making processes into clinical practice across a range of conditions for which multiple treatment options are available. The Group Health Demonstration Project, conducted during 2009-11, yielded five key lessons for successful implementation, including the synergy between efforts to reduce practice variation and increase shared decision making; the need to support modifications in practice with changes in physician training and culture; and the value of identifying best implementation methods through constant evaluation and iterative improvement. These lessons, and the legislated provisions that supported successful implementation, can guide other states and health care institutions moving toward informed patient choice as the standard of care for medical decision making.view more