...Assignment 5: Dealing with Fraud Qui Tam is defined by the phrase “he who sues for the king as well as for himself.” This is a type of legal case in which the whistle-blower or relator files on behalf of the government. The government can then decide to take over the prosecution or not. If the government chooses not to proceed with the case, the relator may continue alone (Showalter, 2012). In order to file a suit, both the plaintiff and the allegations must meet certain guidelines. The same allegations should not have been brought to light previously, unless the qui tam plaintiff is the original source of information that was previously disclosed. The federal law provides a solution for whistle-blowers who are discharged, demoted, harassed, or discriminated against. This type of law suit has become popular and effective in fighting fraud and abuse because of this protection (Showalter, 2012). In healthcare, sometimes the qui tam plaintiffs argue that a claim involving a kickback or an illegal doctor self-referral is a violation of the False Claims Act (FCA). The case may be legitimate otherwise. One case is the United States ex rel. Marcus v. Hess. In this WWII case the contractor’s claims were fraudulent because the contract was secured through collusion. Another case, United States ex. rel. Woodard v. Country View Care Center, Inc. involved defendants who submitted cost reports to Medicare payments to “consultants” that was really kickbacks for referrals. The FCA applied...
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...Assignment # 1- Law and Health Care Keisha Love Health Care Policy, Law and Ethics HSA515 Dr. Melody Princes-Kelley Thousand Oaks Campus January 23, 2012 1. Identify and explain the four elements of proof necessary for a plaintiff to prove a negligence case. A plaintiff suing for medical malpractice has the burden of proof to show the four elements necessary to prove negligence. The standard four-element account of negligence is duty of care, breach of duty, injury, and proximate cause. A person accused of malpractice can defend him or herself by showing that one of these elements is missing and/or by establishing an affirmative defense. “The existence of a duty of care exists because of the contractual relationship between the patient and the doctor, hospital, or other health care provider. When the physician-patient relationship is established, the physician has a duty to possess the medical knowledge required of a reasonably competent medical practitioner (health care provider) engaged in the same specialty. And possess the skills required of a reasonably competent health care practitioner engaged in the same specialty. Also exercise the care in the application of that knowledge and skill to be expected of a reasonably competent health care...
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...Running head: LAW AND HEALTH CARE SYSTEM ADMINISTRATION Assignment #1 Jennifer Smith HSA 515 Dr. Mezu October 27, 2013 Justify your position about the importance of the physician-patient and hospital-patient relationships. The doctor–patient relationship has been and remains a keystone of care: the medium in which data are gathered, diagnoses and plans are made, compliance is accomplished, and healing, patient activation, and support are provided. To managed care organizations, its importance rests also on market savvy: satisfaction with the doctor–patient relationship is a critical factor in people's decisions to join and stay with a specific organization. A patient must have confidence in the competence of their physician and must feel that they can confide in him or her. For most physicians, the establishment of good rapport with a patient is important (Lipkin 2012). Some medical specialties, such as psychiatry and family medicine, emphasize the physician-patient relationship more than others, such as pathology or radiology. The quality of the patient-physician relationship is important to both parties. The better the relationship in terms of mutual respect, knowledge, trust, shared values and perspectives about disease and life, and time available, the better will be the amount and quality of information about the patient's disease transferred in both directions, enhancing accuracy of diagnosis and increasing the patient's knowledge about the disease...
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...As a health care administrator, your legal actions have legal implications and are implicitly and explicitly based on law. Any omissions in the conduct of your duties on your part are also governed by law. Consider the basic governance of a health care setting and how your roles as a top administrator in this setting are affected by the legal system. A healthcare system is like any other organization or society in the instance that it needs rules, communication, and active acknowledgement of each person’s responsibilities and roles among those involved in the system to succeed. As administrators we must do what needs to be done in order to ensure that the system succeeds not only for the benefit of the health care organization itself but more importantly for those that depend on the system, the patients that need our care. Not only do we need to know what it takes to make a health care system work, but we also need to understand the law that the system needs to abide by and make sure those laws are put forth in our actions. According to the Dowton Consulting International Journal, some of the problems with the governance within the healthcare system are: “one of the elements (corporate or clinical governance) is weak or underperforming; the linkages between corporate and clinical governance are not understood and respected inside the organization; and the boundaries between corporate and clinical governance are not effectively managed.” Now the corporate layout is made up of...
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...HSA 515 MIDTERM EXAM PART 1 AND 2 To purchase this visit following link: http://www.activitymode.com/product/hsa-515-midterm-exam-part-1-and-2/ Contact us at: SUPPORT@ACTIVITYMODE.COM HSA 515 MIDTERM EXAM PART 1 AND 2 Part:1 Course: Health Care Policy, Law And Et Test: Week 5 Midterm Exam Part 1 Attempt Score: 125 out of 125 points Time Elapsed 28 minutes out of 2 hours. Instructions: This midterm exam consists of 25 multiple choice questions and covers the material in Chapters 1 through 3. Question 1 5 out of 5 points The person often referred to as the first hospital administrator Question 2 5 out of 5 points Reform in medical education early in the 20th century was due to Question 3 5 out of 5 points The inventor of the electrocardiograph, which marked the beginning of medicine in the 20th century Question 4 5 out of 5 points The first incorporated hospital in the U.S. was founded in Question 5 5 out of 5 points The person who claimed that the alarming number of deaths from puerperal fever was due to infection transmitted by students who came directly from the dissecting room to take care of maternity patients Question 6 5 out of 5 points With the goal of providing the best professional, scientific and humanitarian care possible, the focus of efforts in hospital standardization was the Question 7 5 out of 5 points HSA 515 MIDTERM EXAM PART 1 AND 2 To purchase this visit following link: http://www.activitymode.com/product/hsa-515-midterm-exam-part-1-and-2/ ...
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...Legal and Ethical Considerations in Marketing, Product Safety, and Intellectual Property LaMeka Wright Strayer University LEG 500 June 11, 2014 Samuel Christian, Jr. Legal and Ethical Considerations in Marketing, Product Safety, and Intellectual Property Being a worldwide successful company takes a lot of hardworking individuals to make this happen. When running a successful company, you will want to make sure you are functioning in an ethical manner and are abiding by the law. “PharmaCare is one of the world’s most successful pharmaceutical companies with a reputation as a caring, ethical, and well-run company that produced high-quality products that saved millions of lives and enhanced the quality of life for millions of others” according to the scenario. However, there has been some unethical behavior going on that involves issues relating to marketing and advertising, intellectual property, and regulation of product safety. This paper will discuss some ethical issues relating to marketing and advertising, intellectual property, and regulation of product safety; argue for or against Direct-to-Consumer marketing by drug companies; determine who regulates compounding pharmacies under the current regulatory scheme, what the Food and Drug Administration (FDA) could/should have done in this scenario, and whether the FDA should be granted more power over compounding pharmacies; decide whether PharmaCare’s use of Colberian intellectual property would be ethical in accordance...
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...Small Non-Profit Hospital in Crisis: Small non-profit Hospital Mark Good HSA 515 Dr. Griffin 04/24/2011 HSA 515 P. 2 An exchange of "legal consideration" whether it be financial or of another sort between the parties to a contractual arrangement is crucial for the agreement to be legally enforceable. Each of the parties to a legal agreement must give and receive something of value in order for the written arrangement to be legally enforceable. The 'something of value' may be either something that the person actually hands over (that they would not otherwise be indebted to hand over) or some right that they give up (that they would otherwise have been entitled to exercise). Is the Hospital Negligent or are the nurses negligent? The question of which entity to bring the lawsuit against, the hospital or the care givers, typically depends on the working arrangement or relationship of the physician to the hospital. If the staff member, including support staff, was directly employed by the hospital then the hospital itself would be considered liable. In most situations the staff included as hospital employees would encompass lab and hospital technicians, emergency room staff, paramedics and nursing staff. Doctors and other medical specialists, including surgeons, are typically subcontracted under the hospital and therefore may be held liable rather than the hospital. In some situations the...
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...The Impaired Employee and Liability Shontae Brown May 13, 2012 Dr. David Tataw HSA 515 Identify and explain at least three ethical considerations. 1. If the company decides to hire the candidate solely based on the fact that they have a condition that could result into a disability; that would be considered unethical. The company could be trying to make their company image better by employing more persons with disabilities. 2. If the candidate worked for one of our competitors in the past, it would be unethical of us to hired them just based on that reason alone. Identify and explain at least three the legal considerations. 1. If they hire this candidate and then want to later fire them, they can only fire them under three conditions. The termination must be unrelated to the disability. The employee does not meet legitimate requirements for the job, such as performance or production standards, with or without reasonable accommodation. The employee’s disability poses a direct threat to health or safety in the workplace. If these are not followed then the company could face legal actions. (Fire 2020) 2. If the company decided not to hire the candidate based on the fact of his possible disability then the candidate could file a lawsuit against the company for not hiring him based on the fact that he disclosed that information during his interview. Identify and explain at least three business considerations. 1. When the search committee decides...
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...Assignment 2 HSA 515 Marlo Alcala July 19, 2011 Professor Forbes Assignment Two Scenario: You are the Chief Executive Officer at a small non-profit community hospital. In January the area was hit by a large snow storm while you were vacationing in the Bahamas. Many of the hospital staff who provided patient care called out from work on the 3-11 and 11-7 shifts. Despite efforts from the nurse managers to get relief staff, only one nurse agreed to come in. As a result, the patient units were understaffed and health care personnel on day shift were required to remain on their assigned unit until they were relieved from duty. During the course of this occurrence several patients sustained minor injuries from falls out of bed and one patient was given the incorrect medication, resulting in death. The nurse on duty left the hospital to buy dinner at the corner Wendy’s Restaurant. After one year, the families of these patients sued the hospital on behalf of their deceased relatives, and you are one of the parties mentioned in the suit. The hospital refused liability, stating that: the patients who sustained a fall were awake, oriented and experienced no limitation in mobility; the patient who was given the incorrect medication died not from staff negligence, but from an unidentified allergic reaction to a food substance and had no history of allergies. Question 1 Identify and explain at least three legal considerations. I was the CEO of a non-profit hospital when we were...
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...Legal Aspects of U. S. Health Care System Administration Lillie Cox Dr. A. M. Miller HSA 515 Health Care Policy, Law, and Ethics October 31, 2014 Legal Aspects of U. S. Health Care System Administration In the United States health care administration, there are lots of health laws, such as federal, state and local. The administrator will need to know these laws, because they will be interacting with top professionals at all levels. The health administrator is new to Well Care Hospital, and the hospital for the past six months has been under scrutiny for breach of medical compliance. It is important that the top administrator be concerned about the importance of his or her conduct within the health care setting; compromise the boundaries of ethics and medical conduct. This paper will also discuss the four elements required of a plaintiff, to prove medical negligence and the duties of the health care governing board in mitigating the effects of medical non-compliance, as they apply to the rules of practice set forth in the Well Care Hospital governing board manifesto. As the top health administrator, professional conduct is very important. The staff is to conduct themselves likewise. There is no room for a lot of playing around, because patients, family members, hospital directors, and the administrators are depending on each and everyone to set their difference aside, and be the professional they are. According to Wolper...
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...Assignment 2 By Alfred Onyekaba HSA 515 Health Care Policy Law & Ethics Denise Pica-Branco, Ph.D. Strayer University Identify and explain at least three legal considerations When considering the legalities of this scenario, negligence, vicarious liability, and physician- patient relationship are a few components that affect the outcome of a lawsuit. The amount of legal torts that were violated in this case was enough to cause disputes between patients and healthcare staff. Negligence is a familiar tort that occurs much more than it needs too. Unfortunately in this case, vicarious liability and patient-physician relationship are two considerations that influence this case as well. According to (Dictionary.com), negligence is defined as “the failures to exercise that degree of care that, in the circumstances, the law requires for the protection of other persons or those interests of other persons that may be injuriously affected by the want of such care” (2012). The proximate cause which led to negligence, was Identified when a nurse gave an incorrect medication to a patient who later died. Whether or not the patient died from this malpractice, the hospital was still liable for this tort. In addition, failing to administer proper care to patients directly impacts the patient-physician relationship, which by law can be a breach of contract. Physicians have an implied service agreement that is exercised as soon as they accept to render patients...
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...The Feeding Tube Class HSA 515 Assignment 4: The Feeding Tube Write a 4 to 6 page paper based on your answers to the corresponding questions for the following scenario: Scenario: June, a 34-year-old divorced woman diagnosed with severe anorexia, is hospitalized. Her doctors feel she may need to be placed on a feeding tube soon to save her life. Initially June agreed to the feeding tube. However, in the evening (before the tube has been placed), she became combative, disoriented, and refused to have the feeding tube placed. Her mother and father insisted that the feeding tube be inserted despite her refusal to allow it. Her ex-husband wishes to uphold June’s decision. The hospital administrators seek risk management for legal counsel. Utilize your Showalter textbook and at least two other sources to answer the following questions: 1. Explain how the Patient Bill of Rights applies to this situation. The U.S constitution is called the supreme law of the land because it sets standards against which all other laws are judged. The constitution is a grant of power from the states to the federal government. The constitution is a grant of power from the states to the federal government. This grant of power to the federal government is both express and implied. The U.S congress levy and collect taxes, borrow and coin money, declare war, raise and support armies. Congress may also enact laws that are necessary and proper for exercising these expressive powers. ...
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...Assisted Suicide Dr. Wendy Whitner Health care Policy, Law and Ethnic-HSA 515 June 12, 2011 1. Explain how the Patient Bill of Rights applies to this case. Nurse Nancy is violating the Patient Bill of Rights because Mrs. Jones did not make her own decision to end her life as a form of treatment. Mrs. Jones has the right to be involved in every aspect of treatment and can refuse treatment at any time. The patient is expecting reasonable continuity of care even though she might die. The patient’s doctor is supposed to inform Mrs. Jones if her condition is worsening and if she needs to seek different treatment options. Nurse Nancy did not ask the patient if she wanted to die, she just assumed because the patient is very ill that she may want to end her life. 2. Identify and explain at least three ethical considerations. Ethically it is a nurse’s job to help the doctor preserve a patient’s life. However, Nurse Nancy is the one that is with Mrs. Jones more and sees the drastic effect that the cancer has taken on her. Nurse Nancy has compassion for Mrs. Jones and knows that she is suffering from cancer, so to alleviate the pain she wants to help her end her life. Nurse Nancy needs to ask Mrs. Jones if she wants to die early because of her status as a single mom. In the event that Mrs. Jones does want Nurse Nancy to help her end her life she will need to make preparations for the care of child. Secondly, is it right...
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...Name: Alhassan Kamara STUDENT ID: 200016162 Course: HSA 515 (Health care, Policy, Law, and Ethics) Instructor: Dr. Harold Griffin Due date: 03/11/2012 In this paper, I am taking on the role of manager of a cancer center in a small, suburban hospital. I am dealing with a lot. The nursing staff has expressed burn out because of an increase of terminal cancer patients. In one extreme case, Nurse Nancy feeling empathy for a rapid decline in one of the patient’s health (a 30 year old single mother), want to give an extra dose of narcotic drugs that could potentially end the patient’s life, and what Nurse Nancy perceives as her suffering. Q1. Explain how the Patient Bill of Rights applies to this case. The Patient’s Bill of Rights is the colloquial term for the Consumer Bill of Rights and Responsibilities which was taken up in 1998 by the U.S. Advisory Commission on Consumer Protection and Quality in the Health Care Industry. This deals with a number of areas concerning patient rights, including information for patient’s, the right to choose a healthcare provider, access to emergency care, the right to make decision regarding care and the principle of autonomy, respect and non- discrimination, confidentiality at the way in which complaints should be handle fairly. The bill also notes the responsibility of the patients to take care of themselves. When looking at the potential issue of assisted suicide this is a controversial subject, in this case there...
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...Organization and Management of a Health Care Policy HSA 515 – Health Care Policy, Law, and Ethics August 13, 2015 With lives in their hands, hospitals have to function very precisely, executing high-quality services every hour of every day. Organizations that have this sort of requirement usually take on a vertical organizational structure that is having many layers of management, with most of the organization’s staff working in very specific, narrow, low authority roles. The numerous layers of management are designed to make sure that no one person can throw the system off too much. This structure also ensures that tasks are being done exactly and correctly. Organizational structure of a hospital refers to the levels of management within a hospital. Levels allow efficient management of hospital departments. The structure also helps one to understand the hospital’s chain of command. Organizational structure varies from hospital to hospital. Large hospitals have complex organizational structures while smaller hospitals tend to have much simpler organizational structure. A typical organizational structure of a hospital would usually be a combination of a hierarchical and divisional structure, since there is a chain of command where some levels are under another level, but employees are organized in departments or divisions that have their own roles. At the top of the structure would be the administrators, followed by the information services and therapeutic services. Both...
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