Special issue on Healthcare Law
Call for papers
International Journal of Pharmaceutical and Healthcare Marketing (IJPHM)
Special issue on Healthcare law
Guest Editor: Vivek Pande, University of Wisconsin – La Crosse, USA
Introduction and theme
The passage of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (colloquially lumped together as ``Obamacare''), the upholding of their constitutionality by the US Supreme Court in National Federation of Independent Business v. Sebelius, 567 US ___, Slip Op., Nos. 11-393,11-398, and 11-400 (2012), and President Obama's subsequent reelection on November 5, 2012, have collectively transformed the landscape of US healthcare and its regulation. These are arguably the most sweeping changes in healthcare law since the enactment of Medicare and Medicaid almost 50 years ago.
Yet much of the implementation of these laws remains uncertain, as is their effect on healthcare and pharmaceutical marketing. For example, though the process of establishing health insurance exchanges at the state level is underway, it is not clear how much of a marketing opportunity they would provide to health insurance and pharmaceutical companies. Current guidance from the Department of Health and Human Services is rather scanty and vague – ``Successful Exchanges will adapt to changes in the market by redesigning and modifying business plans as opportunities develop, and will have the flexibility to deal with insurers, agents, and other business partners in a manner that serves the Exchange's interest in maximizing value for consumers''. Yet the same document (Initial Guidance to States on Exchanges) later states that health insurance plan benefit options must be presented in a ``standardized format''. Further regulations are promised and hopefully they will flesh out the details thereby enabling efficient marketing of healthcare services and pharmaceuticals on the new exchanges.
Similarly, other important provisions of the new laws gradually close the Medicare Part D coverage gap (also known as the ``doughnut hole'') by 2020. Though the process of accomplishing this is well- defined, what effect this will have on the prices of branded and generic drugs in the marketplace and the profitability of pharmaceutical companies remains to be seen.
Accordingly, the main goal of this IJPHM special issue is to address the current and future impact of these momentous changes in healthcare law, especially on the marketing of healthcare services and pharmaceuticals. Authors are invited to submit empirical, conceptual or qualitative papers that address the practical and/or theoretical implications of these regulatory changes. However, papers dealing with all aspects of healthcare law (aside from these recent developments) and their effect on the marketing of healthcare and pharmaceuticals are also welcome.
Topics for the special issue
Although manuscripts on any topics related to healthcare law and its effect on the marketing of healthcare and pharmaceuticals are welcome, papers on the following topics are highly encouraged:
.Implementation of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (``Obamacare''), and its effect on the marketing of healthcare services and pharmaceuticals
.Effect of the new laws on the healthcare and pharmaceutical industries, in general
.Establishment of affordable health insurance exchanges – state, federal and federal-state partnerships – and its effect on the marketing of healthcare services and pharmaceuticals
.Restrictions on pharmaceutical reimbursements under a Flexible Spending Account (FSA), Health Savings Account (HSA), or Health Reimbursement Account (HRA) unless medications are purchased with a doctor's prescription
.How filling the ``doughnut hole'' by 2020 will affect the price of branded and generic drugs and impact the profitability of the pharmaceutical industry
.Mandatory Summary of Benefits and Coverage (SBC) and Uniform Glossary – health insurance issuers and group health plans are required to provide consumers with a uniform, easy-to-understand summary about a health plan's benefits and coverage to help them better understand and evaluate their health insurance choices
.State Consumer Assistance Programs (CAPs) and available federal grants to start or strengthen them
.Newly covered preventive services including the controversy over mandatory coverage for contraceptives
.Rules governing choice of doctors and access to emergency room care
.Mistakes in insurance applications and the right of insurers to rescind coverage on account of these ``honest'' mistakes
.Changes in rules governing coverage of pre-existing conditions and coverage under the new Pre-Existing Condition Insurance Plan (PCIP)
.Coverage of adults under age 26 on parents' health insurance plans
.Coverage under the new Consumer Operated and Oriented Plans (CO-OPs)
.Mandate that insurers spend at least 80-85 per cent of premiums on patient care and quality improvement
.Disallowance of lifetime and annual dollar limits on benefits
.State Rate Review programs under which health insurers must justify any rate increase of 10 per cent or more before the increase takes effect
.Healthcare fraud in general and/or Medicare/Medicaid fraud in particular, especially in light of the new resources being made available to combat this fraud
.New Early Retiree Reinsurance Program (ERRP) which provides $5 billion in financial assistance to maintain coverage for early retirees age 55 and older who are not yet eligible for Medicare
.High deductible health plans
.The fiscal ``cliff'' and possible drastic cuts in Medicare reimbursement to physicians
.CLASS (the Community Living Assistance Services and Supports Act) – the long-term care insurance program and its future (or lack thereof)
.``Cadillac'' health plans and associated taxation and marketing.
Quantitative and qualitative studies, legal analysis, experiments, correlational studies, causal studies, comparative studies, descriptive studies, literature reviews, meta-analysis, case studies, viewpoint articles, pedagogical innovations, and book reviews are all welcome. Papers can adopt a historical, current or future perspective.
Manuscripts should be submitted no later than August 31, 2013. The special issue is expected to be published in 2014. All manuscripts will be subject to double-blind peer review and should follow the general guidelines for authors of the IJPHM found at: www.emeraldinsight. com/products/journals/author_guidelines.htm?id=ijphm &PHPSESSID=ig303emu0v42janr40fu34osf2
Submissions to the special issue should be made using ScholarOne Manuscripts, the online submission and peer review system. Registration and access is available at: http://mc.manuscriptcentral. com/ijphm. Full information and guidance on using ScholarOne Manuscripts is available at the Emerald ScholarOne Manuscripts Support Centre: http://msc.emeraldinsight.com
Please contact the Guest Editor of this special issue at the following
e-mail address, if you have any questions: Vivek Pande at: [email protected]