Failure to protect a patient's medical records under the Health Insurance Portability and Accountability Act (HIPPA), for example, could result in fines or costly legal battles. As the compliance officer of a large multispecialty health care organization located in the Southeastern United States, my organization is privately held and is located in a large metropo, Choose a health care issue with controversial ethical and legal implications. Have a question or concern about this article? Read our Privacy Policy. The online class explores the legal, policy and ethical issues encountered by healthcare professionals and patients in the healthcare system. Data Breaches: Cybercrimes affect every major industry in the United States, including healthcare. I need to research the literature, analyze the alternatives, and present a conclusion (take a stand). Doing background checks to make sure that they havent been involved in cases like this in the past is always recommended as well. Medical malpractice is not a new legal problem, but its one that isnt going to go away anytime soon and it may become more complicated as the healthcare industry becomes more reliant on technology for treating patients. - Identify internal and external factors that impact hospital operations. that need to be worked out. The following studies illustrate the problem: Healthcare organizations need to devote resources to improve health equity and can start by taking the following steps: For many Americans, access to care has always been problematic, but a recent CDC study found that four in 10 U.S. adults have avoided access to care due to issues surrounding the COVID-19 pandemic. The added complexities of the COVID-19 pandemic, in particular, have had a great impact on laws affecting healthcare this year. Online attacks are on the rise and its up to the practice to take the necessary steps to protect all of the patient information that they hold. - Examine the situations or concerns that brought attention to the issues addressed by the law. In this process, both parties have the opportunity to ask questions and exchange relevant information related to the diagnosis and treatment of the patient. The laws around new technology like this are tricky because its uncharted territory and a lot of the time, the legal system is playing catch-up. Include the following in your summary: The doctor has a license where they are, but they dont have one where the patient is. In the medical business, it relates to claims for Medicare and Medicaid payments and if false claims are made, the medical practice can be held accountable as well as the patient themselves. Starting a business always comes with legal challenges and its important that a new business owner understands and follows the laws that apply to their company. symplr Compliance offers legal and regulatory content in its risk assessment management module of our powerful and flexible platform. Analyze the trends in the U.S. healthcare system and potential implications from both the patient and provider perspective. Discuss an event in which you had to make an ethical decision. The False Claims Act is designed to stop fraud against the government. Innovations make it easier for doctors to accurately diagnose problems and treatments are becoming more effective all of the time, which is great news. p(i,6>lYw&'u0,uGz4pWA0a`i-
n[y[HKsv* /d'3bP:Y$,lUE`&YGXb>u~C S'na,GH +u=y6mFJ]H7Xji`>P?5.'9(40[@%K. Discuss the problem-solving methodologies you used to resolve the issue. When it comes to medical malpractice law, the penalties are steep and its likely that the doctor will lose their license. Telehealth providers should take a proactive stance in reviewing their billed claims and the compliance of their telehealth programs to ensure they are in keeping with federal requirements. OCR states that its undertaking this initiative to support individuals right to timely access of their health records at a reasonable cost under the HIPAA Privacy Rule. OCR often investigates a provider for a single instance of alleged failure to respond timely to a patients records request. Worker Adjustment and Retraining Notification Act (WARN): Requires employers of 100 or more employees to provide advance notice to employees when either permanently closing a job location or implementing a mass layoff. Before we become involved in these specific laws, explain what is meant by law and how laws affect how the HIM professional manages privacy and confidentiality. Stark Law: The Stark Law includes provisions to prevent healthcare fraud in the area of physician referrals. Submit an actual fire drill log, which verifies compliance with fire safety co, In memo format, inform a member of your Congress on the issue of gun control: background checks to sales at gun shows, in-state transactions made over the Internet, and other commercially advertised sales. Identify how ethical theories impact professional. A major proposed update includes allowing patients access to inspect their PHI in person and to take notes or photographs of their PHI. like money as well as dinners, drinks, entertainment, and travel. If medical practices are not up to date with current legislation and they dont have a clear understanding of how new developments affect them, its likely that theyll end up in some serious legal trouble. All doctors must take the Hippocratic oath and promise that they will do their utmost to help patients and will not harm them further, but sometimes, doctors break that oath. The Department of Justice (DOJ) recovered more than $2.2 billion in settlements and judgments related to the False Claims Act (FCA) in 2020, $1.8 billion of it related to the healthcare industry. Labor issuesespecially allegations of retaliation, wrongful termination, or wrongful denial of leaveaccount for a significant percentage of the recent COVID-19-related lawsuits brought by employees. The False Claims Act also covers instances of pharmaceutical companies encouraging medical practices to overuse their products by offering them incentives like money as well as dinners, drinks, entertainment, and travel. Legal rights for the patient, as well as the actual liability associated with the health care worker and the health care facility may be different depending on whether the concept of "apparent agency" or ", Using the South University online library, the Internet, and the data from the Organization for Economic Cooperation and Development (OECD), research comparative international work and compare the United States and Canada with respect to which country is more effective in the areas of (1) economic growth; (2) expenditure (public, My Objective: When an, When a medical accident or malpractice occurs, the patient and/or family need to gather information related to the accident. She also writes for Real Estate Agent Magazine. This website uses cookies so that we can provide you with the best user experience possible. and often, it is a rival medical practice that is involved because they want to gain an edge over their competitors. Our provider data management, workforce management, and healthcare governance, risk management, and compliance (GRC) solutions improve the efficiency of healthcare operations, enabling caregivers do what they do best provide high-quality patient care. You are the supervisor and have 1 position open for a floor registered nurse (RN). For example, a doctor needs to be licensed to practice medicine in the state that theyre treating patients in, but what if the patient is in a different state where the doctor doesnt have a license? But it does raise questions when the doctor and the patient are in different locations. Support your position with reasons why you believe the aspect of the. Telemedicine is defined as the delivery of medical advice using electronic communications, between a patient in one location and a doctor in another. Consider that Medicare is a federal program that is 100% financed by the federal government and Medicaid is a shared financial responsibility between federal and states governments? 
They are not required for the site to work. The largest recoveries were from drug manufacturers that funded co-payments of Medicare patients to protect high drug prices: Two pharmaceutical manufacturers paid more than $148 million each to resolve claims that they illegally paid patient copays for their own drugs. The FCA is the basis for combating healthcare fraud and is the civil tool for the DOJ to redress false claims for federal funds. 
Further, 12% of adults have neglected emergency care during the pandemic, and 32% have gone without routine care. endobj
MBA with a Concentration in Supply Chain Management, MBA with a Concentration in Financial Services, MBA with a Concentration in Business Analytics, MBA with a Concentration in Healthcare Administration, MBA with a Concentration in Forensic Accounting, M.A.Ed. - Describe the process of passing this health care law from conception through signing, All tasks performed by Health Information Professionals are governed by laws. Telemedicine is one of the latest innovations in medicine and its having a big impact on the healthcare industry, but there are a lot of legal issues surrounding it that need to be worked out. For example, a doctor needs to be licensed to practice medicine in the state that theyre treating patients in, but what if the patient is in a different state where the doctor doesnt have a license? HIPAA: This act protects patient privacy with regard to medical treatments and records. If a patient is harmed through deliberate action or, most likely, negligence by a doctor, that medical practice is likely to find itself on the end of a medical malpractice lawsuit. However, even if the provider has a valid reason for delay, the request must be fulfilled within 60 days of the initial request with only one extension allowed per patient. Submit an exercise for all employees regarding abuse and neglect. Visit one of the following websites: www.jointcommission.org, www.aha.org, and www.ncqa. End with, Part 1: Research to find the laws and regulations which apply to life the end of life; Fadiman compares the Hmong to a visual perception puzzle (p.237). However, it is not possible to completely avoid cyber-attacks as criminals will find ways around security software as it is updated, which means that preparation is important as well. An online healthcare-focused MBA from UNCP is one way to equip yourself with the skills and know-how to adapt to the changing legal landscape. Need help with a healthcare class on legal and ethical topics. (J3g#$}p,s7DeuY-@ n`J{07eYnAVRWfB#ZwoP>aHCpC1T$~oWN5CZ u1Z|U'
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.1#() {Jj The government paid out $309 million in 2020 to whistleblowers. There are five main categories of strategies used: Two basic healthcare torts exist in the United States. If a medical practice is offering telemedicine services to a patient that hasnt had a standard appointment with their physician, they could be on the wrong side of the law. we learned that providing quality care is not just good ethics, it is good business. 2020 was quite a year for telehealth law; the already growing area of law expanded exponentially, with waivers to decrease telehealth payment barriers, measures to protect patients, and audits to reduce fraud as stand-outs. Thats why its more important than ever for medical practices to ensure that theyre checking all payments properly and reporting any mistakes, no matter how minor. Growth in national health spending closely tracked growth in nominal gross domestic product (GDP) in 2010 and 2011, and health spending as a share of GDP remained stable from 2009 through 2011, at 17.9 percent (Micah et al., 2011). <>
with a specialization in Elementary Education, M.A.T. For example, if a provider doesnt give appropriate care and a patients health is harmed. The Affordable Care Act has worked to increase insurance coverage to a greater percentage of Americans. In 2011, Maryland-based Cignet Health was fined $4.3 million for a regulatory compliance issue and for failure to cooperate with the subsequent Health and Human Services investigation. Medical malpractice insurance is another problem because it doesnt often cover telemedicine. 2 0 obj
Informed consent is the communication process involving a health care provider and a patient. The medical business itself may also be forced to close in some cases, so its vital that the situation is avoided at all costs. In addition, the Medicaid Expansion aspects of the Act have helped narrow disparities in health coverage and access to care. The Public Readiness and Emergency Preparedness Act (PREP Act) contains declarations that authorize healthcare personnel to use telehealth across state lines to order or administer covered countermeasures and to provide telehealth providers immunity from liability for claims concerning those countermeasures. Compliance for Tax-Exempt Hospitals: Hospitals that wish to maintain their charity status must provide certain services that add to the general welfare of the communities they serve. - Identify dilemmas that threaten the future integrity of the U.S. healthcare system. Other significant changes include CDCs requirements for LTC and nursing facilities to report COVID-19 data weekly on: Nursing facilities also are required to provide information about suspected and confirmed COVID-19 cases among residents and staff to residents and their families, within certain time frames. This means that every time you visit this website you will need to enable or disable cookies again. The healthcare industry is continually evolving, and new laws that regulate healthcare are passed each year at the federal, state and local levels. 844-302-7886, document.write(new Date().getFullYear()); The University of North Carolina at Pembroke Medical practices are required to take steps to protect the private patient information under HIPAA. Because whistleblowers have inside information that is critical to identifying potential fraud in an organization that the DOJ would not have otherwise, the whistleblower shares in the money the DOJ recovers. Explain all components, including how the abuse is reported to the proper agency in New York State. Weve seen this reflected in discrepancies in medical care among minorities with regard to access to healthcare, testing, and vaccination throughout the COVID-19 pandemic. All medical practices need a dedicated IT team that can properly implement the right security software and keep it updated as necessary, so the likelihood of an attack is reduced. When youre treating patients and their lives are in your hands, its important that everything is done correctly and held to a high standard, which is why there are so many rules and regulations around healthcare. An increase in settlements holding individuals responsible: In several FCA examples in 2020, individual doctors from a medical practice agreed to pay large amounts (in one case $4.25 million) to resolve civil allegations related to illegal kickbacks. All medical practices need a dedicated IT team that can properly implement the right security software and keep it updated as necessary, so the likelihood of an attack is reduced. Barriers to access to healthcare could be due to poor access to transportation or limited healthcare resources, but the most significant barrier is a lack of insurance coverage. In the medical industry, its particularly important because the data that they hold about patients is far more sensitive than any other business, which is why there are strict laws around data protection compliance in healthcare businesses. But some industries experience far more legal problems than others and the medical industry, in particular, is a legal minefield. In particular, two federal acts addressing the pandemic to be aware of are: Long-term care (LTC) facilities, nursing homes, and skilled nursing facilities have been hit hard by the COVID-19 pandemic, and as a result there are new federal guidance and requirements to ensure quality of care for these entities. In the past, HIPAA compliance wasnt a huge expense for medical businesses but technological advancement means that everything is stored online now and a lot of new medical equipment also holds information about patients. If a patient is harmed through deliberate action or, most likely, negligence by a doctor, that medical practice is likely to find itself on the end of a medical malpractice lawsuit. Poten, BrainMass Inc. brainmass.com July 21, 2022, 1:34 am ad1c9bdddf, Immorality, and evidence-based medical practice and culture, Circumstances resulting in removing a child from their guardian, Analyze a Case in: Assisted Suicide (Bouvia v. Superior Court), Economic development parameters between the USA and Canada, Legal and Ethical Issues of Patient Selection in Hospitals, Assessing the Patient Protection and Affordable Care Act, Difference between privacy, and confidentiality, Center for Medicare and Medicaid Services: Reimbursement, Ethics and the Job Applicant Selection Process, Fair Labor Standards Act - Significance in Healthcare, Future Integrity of U.S. Healthcare: Internal & External Factors, Long Term Health Care Facilities and Elderly Abuse Complaints, Healthy Policy - Gun Control - Expanding Gun Laws, Health care profession's legal and moral stance. Its so important that medical practices always prioritize patient care and choose the best treatments for them, rather than allowing themselves to be swayed by incentives to pharmaceutical companies. You have two final candidates who are both registered, licensed, have 5-7 years of experience, have great recommendations, and either would be a competent choice. 
to ensure that they have the protection that they need. These will continue throughout 2021, and providers need to understand the changing guidance from CMS. The proposed updates center around a patients right to access protected health information (PHI) while also reducing barriers to healthcare operations and value-based reimbursement systems. The issue must be an HR issue in healthcare. Suspected and confirmed cases among residents and staff, Total deaths and COVID-19 deaths among residents and staff, Amount of PPE supplies and ventilator capacity in the facility. The Health Insurance Portability and Accountability Act (HIPAA) was passed in order to protect the healthcare records of patients and ensure that all medical practices were following proper procedure to protect that data. There are a wide range of regulatory strategies that can be used to ensure societys health and safety. Here are just a few of those issues. Its very beneficial because it means that doctors can be more flexible and help patients that cant necessarily get to the practice easily. Privacy Policy. These are reasons why the University of North Carolina at Pembroke's online Master of Business Administration in Healthcare Administration offers a course on legal and ethical issues. As a result, yo, Write a 350- to 700-word summary. These services include but are not limited to Hotjar, Ad scripts, and Google Analytics. (There is no time frame during which the case must have occurred; however, the case must be analyzed in the context of laws and policies that existed at t, Last night, I got an email from Medscape (I get these regularly) entitled the "Congress sends ACA repeal to President, who Promises Veto". Following the laws that govern healthcare can quite literally save lives. However, not all states have expanded Medicaid. However, that new technology does often bring new legal challenges along with it. hbspt.cta._relativeUrls=true;hbspt.cta.load(450473, '3d6aa2b3-67fb-46fc-85ca-96aa8ac5b187', {"useNewLoader":"true","region":"na1"}); symplr is the leader in enterprise healthcare operations software and services. These duties are derived from statutes, regulations, principles of laws, and the organization's own policies and procedures. It seems both the House and the Senate have started working on repealing the act, cutting the spending budget to strengthen the nation, and will address a new health care reform (this is th, Review the following scenarios. CMS recently updated its guidance for revised visitation recommendations and is now allowing responsible indoor visitation at all times and for all residents, regardless of vaccination status of the resident or visitor, except under certain circumstances that should limit visitation (e.g., confirmed COVID-19 status or quarantine). This website uses additional cookies that mainly assist with our marketing efforts. That means that legislation can change quickly and medical businesses need to ensure that they stay up to date. Innovations make it easier for doctors to accurately diagnose problems and treatments are becoming more effective all of the time, which is great news. In the past, HIPAA compliance wasnt a huge expense for medical businesses but technological advancement means that everything is stored online now and a lot of new medical equipment also holds information about patients. HELLO@SYMPLR.COM 866-373-9725 Legal and Privacy, Cynthia Gallee, JD, RHIA, CHC, Senior Solution Consultant, Fast Facts for Providers Considering Medicaid Enrollment Post COVID-19, How to Overcome Payer Rejection During Enrollment, symplr Roundtable Explores Health Plan Challenges With No Surprises Act. In a substantial post, you will examine whether the ACA is or is not an appropriate law for the United States. Online attacks are. By submitting this form, I am providing my digital signature agreeing that The University of North Carolina at Pembroke (UNCP) may email me or contact me regarding educational services by telephone and/or text message utilizing automated technology or a pre-recorded message at the telephone number(s) provided above. Access to health services is also a key domain of the social determinants of health. The healthcare industry is constantly changing as lawmakers, payers, patients, and other stakeholders adapt to new realities. Its also important to understand the multiple regulations regarding telehealth that have been instituted this year. Is it immoral or insensitive to set evidence-based medical practice over other cultural medical beliefs? I understand this consent is not a condition to attend UNCP or to purchase any other goods or services.
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