...Stephanie Sauceda HCS/545 March 17, 2014 Mary Cummings Health Law and Regulations Health care in the United States has changed over the years and the federal government saw need to establish regulatory agencies such as the Centers for Medicare & Medicaid Services (CMS) to ensure the elderly, disabled and low income receive quality and cost-effective health care. As a result of health care costs sharply increasing, the government determined it needed to have oversight on the health care industry and pushed for the establishment of managed care organizations (MCO). CMS enforces the Emergency Medical Treatment & Labor Act (EMTALA); this act was created to ensure health care organizations provide a minimum of a medical screening exam to determine if complaint is emergent or not. Most importantly for EMTALA is the obligation to treat emergent cases regardless of the patient’s ability to pay for services. In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was approved by the United States Congress to regulate the use of and protect patient health records and the Department of Health & Human Services oversees the compliance and violations of HIPAA (Department of Health & Human Services, n.d.). The intentions of many of these regulatory agencies is to oversee that the health care industry is providing quality, affordable health care and treating patients with fairness and privacy. In 2008, the Centers for Medicare & Medicaid Services (CMS)...
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..."PLEASE SAVE HIM!!" is a sentence heard by Emergency Medical Service professionals (EMS) all over the United States, and as always, there is a rescuer waiting to be dispatched to save a person’s life. Thousands of EMS personnels save lives on a daily basis, not for the paycheck, but for the privilege of saving someone’s life. This has been the case since 1966 when it all started. Emergency Medical Services is a branch of medicine concerned with the treatment of critical and unscheduled patients with illnesses or trauma that requires immediate medical attention. EMS is a new but popular industry in today's society. Since its debut, EMS has changed to meet the demands and needs of its customers in a time-effective manner. To fully grasp the...
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...Abstract The Affordable Care Act (ACA) brings a myriad of changes to the healthcare system and hospitals must adapt accordingly or face dire financial challenges. Some of the financial challenges will originate from the influx of Medicaid patients due to the Medicaid expansion. Based on these changes, there is an increased tendency for hospitals to engineer ways to reduce costs such as patient selection and staff reduction. However, for a hospital to participate in Medicare, which accounts for more than 50% of hospital budgets, certain laws and regulations must be followed. This paper discusses these laws and regulations and offers suggestions on how to adjust successfully to the upcoming changes. The Affordable Care Act (ACA) and Hospital Compliance In light of the current changes in the healthcare industry, it is imperative for every healthcare organization to adapt accordingly or face dire financial challenges. A major change included in the Affordable Care Act (ACA) is the expansion of Medicaid, which will provide coverage to millions of formerly uninsured US citizens and permanent residents (Rosenbaum, 2011). However, Medicaid is notorious for much lower reimbursement compared to Medicare and private/commercial insurance (M. Schmitt, personal communication, October 7, 2013). In addition, hospitals are now required to prove that the services they bill for actually improve and maintain patients’ health (Leonard, 2013). Hospitals are also required...
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...about 70% of them will obtain employment. The jobs that illegal immigrants occupy are the lower end jobs, which hurt unemployment rates especially for the lower class. Illegal Immigrants costs the United States about 113 billion each year. These costs are spread out over our education system, medical care, judicial system, and more. The information presented in this research paper will address the seriousness of this issue. Illegal immigration has a negative impact on the United States in many ways. Immigrants have entered our country illegally and stolen millions of jobs, crippled a struggling education system, manipulated welfare programs, and drastically raised crime rates. Without immigration reform, the crippling effects of illegal immigrants will break this country. With illegal immigrants willing to work for less pay and in poor work conditions, they negatively impact employment rates. Illegal-immigration has a negative impact on the available jobs for U.S. citizens. People often protest that the illegal immigrants do the jobs that Americans don’t want to do. However, that is not the case. They are able to work for low wages and in poor conditions, where citizens must follow minimum wage and labor laws. The more employers use illegal immigrants for cheap labor, the overall wage goes down. As Adam Davidson stated, “When wages go down, American workers are harmed. And when American workers are harmed, the poor are always the first hit.” (Davidson, 2006) Almost...
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...Demographic Paper University of Phoenix Valerye Rogers HCS/490- Health care Consumer- Trends and Marketing Thomas Kehoe, Instructor July 12, 2010 Demographic Paper In the following, the author was designated by the senior management team at a community hospital to write a summary on the effects of changes in population demographics on the needs and services for a selected population. The author must identify the population on which the case study will focus on the aging population, patients with a particular chronic disease, children, patients with AIDS, patients requiring long-term care, or emergency management. The author must identify the targeted population, gather data about the population demographics, and describe the general impact that changing demographics may have on the health care market. The author will discuss why and how the changes in demographics will affect health care. Two health care related challenges identified for the population is chosen. The author will also describe how a chronic disease wellness program may affect the costs for this demographic. In conclusion, the author will discuss the marketing needs or services needed for this population as well as how the chosen population can address these challenges. The population demographics that the author has chosen to write a summary on is the influence of illegal immigrations on emergency health care. Immigration reform is one of the most forming or expressing division or issues opposing the...
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...DOCS Scheduler Company: ACME Express Website: www.docsscheduler.net Country or region: United States Company profile ACME Express is a software development company that focuses on scheduling management for hospitals. Supporting Microsoft software and services Microsoft Azure SQL Database Microsoft Azure Virtual Machines * * “Essentially no IT resources are required to implement DOCS Scheduler, except for due diligence. But with Azure, it’s a no-brainer: Azure helps us satisfy all the medical healthcare regulations in terms of security and privacy. It simplifies the entire due diligence process for IT.” * * Don Scipione, President, ACME Express | | | | | Microsoft Healthcare Solution Case Study | | | | | | | On-call scheduling app consolidates calendars, contact information for hospitals | | | | | “Our mission is to dramatically increase the productivity of healthcare schedulers and to produce a fair schedule for providers, an accurate system for emergency departments, and a low-cost solution for hospitals.” * Don Scipione, President, ACME Express ACME Express is on a quest to revolutionize...
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...Introduction This paper strives to answer questions based on the case study “Emanuel Medical Center: Crisis in the Health Care Industry”. As excerpted directly from the case study, Mr. Robert Moen, Emanuel Medical Center (EMC) president and CEO, was experiencing a number of challenges in 2002. The medical center faced numerous challenges in its external and internal environment. First, EMC garnered an onslaught of negative attention for the “Haley Eckman incident” in which a young man, who happened to be a gang member, died within view of EMC’s Emergency Department (ED) medical personnel rendered no care and watched. The emergency department at EMC was also experiencing greater pressure to deliver services in an increasingly difficult health care environment, particularly after the federal Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted; legislation that required access to emergency medical care for all, regardless of one’s ability to pay. Additionally, larger, for-profit managed care facilities were making substantial advances into EMC’s service area. Internally, the cost of operating the ED had increased significantly and patient traffic had vastly exceeded the capacity for which the ED had been designed. In addition, reimbursements for services from health maintenance organizations (HMO) and government programs had been drastically reduced. At the same time that other regulatory burdens had increased, EMC began to experience labor shortages...
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...HSA 515 DISCUSSION QUESTIONS 1/10/12 Discuss the Stowers v. Wolodzko case questions. 1. What other information would you like to have to fully consider this case? Was she having symptoms of being “mentally ill” before she filed for divorce? Why didn’t husband speak with his wife first and why didn’t the doctor tell Mrs. Stowers the truth as to why he was there at her residence? Was he looking for something when he came to the residence? Did her husband pay/bribe psychiatrist? 2. According to the opinion, Mrs. Stowers was committed on the strength of the statement of two physicians that she was "mentally ill." Would that evidence be sufficient today to have someone committed involuntarily? If not, what would the evidence have to prove? Why? In this case, it does not prove that Mrs. Stowers was a threat to herself or others in her family. It seems as if she was kept away from her family except when it was convenient for her spouse. I do not think that a person could be committed today based on the evidence given in this case. Apparently, she became mentally ill when she filed for divorce. 3. How should these kinds of cases be handled today? If a person is in danger of harming themselves or others, all of the events should be documented so there is a trail of events. Depending on how bad or life threatening the event is, they may involuntarily commit the person and remain in constant contact with the family. How can intentional torts arise...
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...1. Point-Counterpoint State Medicaid Policy and Health Reform Harold A. Pollack University of Chicago Authors: Pollack, Harold A.1 Source: Journal of Health Politics, Policy & Law; Feb2013, Vol. 38 Issue 1, p161-163, 3p The article discusses the positive and negative implications of the new ruling that the federal government could not require states that receive federal funds under the Medicaid program to participate in the Patient Protection and Affordable Care Act's (PPACA's) Medicaid expansion. Several shortcomings like limited provider payment and associated patient access barriers have been observed in Medicaid that make its adoption not a good idea. However, families below the poverty line can benefit. In July 2012, the Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA). The Court thus ended one phase in the political and legal battle over health reform. Yet in doing so, it opened a new front. In a notable departure from post–New Deal commerce clause jurisprudence, the Court ruled that the federal government could not require states that receive federal funds under the Medicaid program to participate in the PPACA’s Medicaid expansion. In effect, the Court made states’ participation in the PPACA’s Medicaid expansion voluntary — a possibility that neither the act’s supporters nor its opponents seriously entertained during the long legislative battle of 2009 and 2010. The full implications of these...
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...False 2. An electronic health record can be managed across more than one healthcare organization. True 3. Confidentiality refers to the right to be left alone. False 4. HITECH widens the scope of privacy and security protections under HIPAA. True 5. Privileged communication is a legal concept designed to protect the communication between two parties. True Check Your Understanding 1.2 1. Ownership of a health record generated by a doctor on a patient belongs to the patient. False 2. A custodian of records is responsible for certifying that a record is what it purports to be. True 3. When a patient refuses treatment he or she is exercising the ethical principle of beneficence. False 4. In a malpractice case, a professional code of ethics may be used as a benchmark for what should be acceptable practice by a healthcare professional. True 5. The ethical principle of nonmaleficence refers to making sure rules are fairly and consistently applied to all. False CHAPTER 2 Check Your Understanding 2.1 1. Private law defines rights and duties between individuals and the government. False 2. Statutes are enacted by legislative bodies. True 3. Administrative law is created by court decisions. False 4. Persuasive authority occurs when a court looks to another court’s decision for guidance, even if it is not required to do so. True 5. Under the theory of stare decisis, a higher court must look to the decision of...
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...Chain Competitive Disadvantages Relative to Weaknesses Appendix O: Strategic Implications of Strengths and Weaknesses References Decision Analysis Decision Analysis Appendices Appendix P: Directional Strategies Appendix Q: Adaptive Strategies Appendix R: Market Entry Strategies Appendix S: Strategic Positioning Appendix T: Value-Chain Funcations References 1 2-11 12-13 14-17 18-29 30-36 37-50 51-60 61-66 67 I-VII 68-74 75-81 82-86 87-91 92-95 96-105 VIII-XV 106-109 110-122 123-125 126-128 129-135 136 Issue Statement Emanuel Medical Center (EMC) is encountering tremendous financial troubles as it struggles to remain open as an independent general acute care hospital. Changes in federal regulations such as the implementation of the EMTALA laws and lower reimbursement rates for federally run insurance programs, changes in service area demographics, and the evolution of the services that locally competing hospitals offer, all have contributed to five consecutive negative operating margins for Emanuel Medical Center. Emanuel Medical Center’s poor infrastructure and inability to adapt to these changes has left the...
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