The Federal Trade Commission, clinical integration, and the organization of physician practice

This article examines Federal Trade Commission (FTC) policy--in particular, the agency's controversial 1996 statements on clinical integration--toward joint negotiations for nonrisk contracts with health plans by physicians organized into independent practice associations (IPAs) and (with hospitals) into physician-hospital organizations (PHOs). The article concludes that the policy is consistent with anti-trust principles, consistent with current thinking on the use of organized processes to improve medical care quality, specific enough to provide guidance to physicians wanting to integrate clinically, and general enough to encourage ongoing innovations in physician organization. The FTC should consider stronger sanctions for IPAs and PHOs whose clinical integration is nothing more than a sham intended to provide cover for joint negotiations, should give the benefit of the doubt to organizations whose clinical integration appears to be reasonably consonant with the statements, and should clarify several ambiguities in the statements. Health plans should facilitate IPA and PHO efforts to improve care by rewarding quality and efficiency and by providing clinically integrated organizations with claims information on individual patients. Though creating clinically integrated organizations is difficult and expensive, physicians should recognize that clinical integration can help them both to gain some negotiating leverage with health plans and to improve the quality of care for their patients.     

"TOO MANY LAWYERS, NOT ENOUGH PRACTICAL PEOPLE": The Policy-Making Discretion of the Federal Trade Commission

Contemporary legal theory recognizes three primary methods of controling administrative discretion: confining through substantive standards, structuring through procedural requirements, and checking through bureaucratic review. It is sometimes assumed that these techniques operate independently and that their effects are additive. This article reports on a study of Federal Trade Commission policy-making and concludes that in some instances there can be complex interactions among the legal techniques for controlling discretion, and between the legal techniques and political or bureaucratic forces shaping policy-making discretion.     

Television Food Marketing to Children Revisited: The Federal Trade Commission Has the Constitutional and Statutory Authority to Regulate

The evidence reveals that young children are targeted by food and beverage advertisers but are unable to comprehend the commercial context and persuasive intent of marketing. Although the First Amendment protects commercial speech, it does not protect deceptive and misleading speech for profit. Marketing directed at children may fall into this category of unprotected speech. Further, children do not have the same First Amendment right to receive speech as adults. For the first time since the Federal Trade Commission's original attempt to regulate marketing to children in the 1970s (termed KidVid), the political, scientific, and legal climate coalesce to make the time well-suited to reevaluate the FTC's authority for action. This paper analyzes the constitutional authority for the FTC to regulate television food marketing directed at children as deceptive in light of the most robust public health evidence on the subject.     

Fines and Justice Administration: The Experience of the Federal Republic of Germany

As part of the penal code revised in 1969, the Federal Republic of Germany increased its reliance on fines, including the introduction of day-fines, in lieu of short-term imprisonment for minor offenses. The previous trend toward the use of fines was accelerated by the requirement that courts order imprisonment only in exceptional cases. Traffic cases were particularly affected. The qualities of the offense and the absence of previous offenses, rather than an individualized study of the offender, continued to be the dominant criterium influencing the choice of a fine. The chief effect of day fines was higher amounts applied to the more affluent defendants; the amount of the fine appeared to have no effect on subsequent recidivism. For first offenders, fines were superior to imprisonment in avoiding reconviction. Day-fines were no more effective (but not less effective) than imprisonment in the instance of traffic offenses. Fines were superior to other sanctions for petty property offenders but not for career thieves.     

Medical participation in control of certain open-panel medical prepayment plans: Federal Trade Commission. Request for comment and advance notice of proposed rulemaking

This Notice requests comments on two staff reports dealing with medical participation in control of Blue Shield and certain other open-panel medical prepayment plans and on alternative courses of action that the Commission might take to deal with this subject, one of which might be rulemaking.     

The Youth Justice and Criminal Evidence Act 1999 andthe interviewing of vulnerable groups: A practitioner's perspective

Purpose. To discover practitioners' appreciation of the legislative changes that the Youth Justice and Criminal Evidence Act 1999, largely implemented in 2002, will have on investigative interviewing of vulnerable groups. Method. Police officers and social workers completed a questionnaire that asked about their perceptions of the Youth Justice and Criminal Justice Act 1999. Results. Practitioners thought that a large number of interviewees would be eligible for the special measures allowed within the remit of the new act. It was believed that the act would result in achieving best evidence with respect to accuracy and recording of interviews and in less discrimination against vulnerable groups. However, it was believed that implementing the act would be demanding in terms of time and money. Conclusion. Police officers and social workers share positive and negative views concerning the implementation and efficacy of the new legislation.     

The Juvenile Justice Reform Act of 2018: Updating the Federal Approach to Youth Involved,and At‐Risk of Becoming Involved,in the Juvenile Justice System

On December 21, 2018, the Juvenile Justice Reform Act was signed into law, marking the first update in 16 years to the Juvenile Justice and Delinquency Prevention Act of 1974, as amended. The reforms reflect much of the knowledge that has been gained through research and science over the past decade and strengthen the Act’s core protections for youth in the juvenile justice system. The changes also expand the Office of Juvenile Justice and Delinquency Prevention’s role in research, and technical assistance, and provide for additional oversight for related programs.     

Argumentation and Legal Interpretation in the Criminal Decisions of the Polish Supreme Court and the German Federal Court of Justice: A Comparative View

The subject of this study are the argumentation strategies applied by the Polish and German apex courts competent in criminal matters, namely the Supreme Court and the Federal Court of Justice, respectively. The investigation encompasses a total of 200 rulings issued by the criminal panels of these bodies. Particular focus was put on examining which arguments both courts apply to solve interpretation problems, and secondly, how these courts systematize the interpretation process. Methodologically, the examination utilizes, inter alia, the principles of qualitative research, without neglecting the legal dogmatic perspective. A crucial theoretical foundation underlying this study is the distinction between formalistic and substantive legal cultures. The examination reveals that neither the Polish nor the German legal culture is purely formalistic or value-oriented. Nevertheless, the Supreme Court of Poland shows greater affinity for formalistic arguments, whereas the substantive interpretation methods are more widespread in the judicature of the German Federal Court of Justice. In particular, the Polish Court prefers the linguistic interpretation, whereas the German Court favours the purposive approach.

     

Police and HIV/AIDS: The risk, the reality, the response

Risk and fear have been examined empirically and theoretically in the policing literature. To date, however, there has been minimal effort to examine these concepts in the context of HIV/AIDS. Since the HIV/AIDS epidemic was first detected nearly 20 years ago, relatively little attention has been given to the complex issues it presents for police officers. The following discussion draws from both the policing and epidemiological literatures to examine police officers’ fear and risk of occupational HIV transmission and individual and departmental responses to this fear. Important elements of educational programs and policies are also addressed.     

Physician agreements to control medical prepayment plans: Federal Trade Commission. Adoption and publication of enforcement policy with respect to physician agreements to control medical prepayment plans

The Federal Trade Commission has adopted, and is publishing with this notice, a statement of enforcement policy with respect to physician agreements to control medical prepayment plans. The statement sets forth the general approach the Commission intends to use in its case-by-case enforcement program for evaluating physician agreements to form, operate, or control such plans and for evaluating the practices of plans that are controlled by a group of physicians.