HC 4420 UOD Legal Fundamentals of Healthcare Revenue Questions
Question Description
Im working on a public health exercise and need an explanation and answer to help me learn.
Be brief but concise and show your comprehension the law and legal issues covered in this course.
(A) You are acting as Counsel for Health Care of Colorado, Inc., a private hospital located in Denver, Colorado. A patient of Dr. Manning, a surgeon, returns to the ER one week post op, with severe stomach pains. A radiologist advises Dr. Manning that a small surgical sponge can be seen on the X-ray. Dr. Manning admits to the radiologist and notifies the Chief of Surgery, Dr. Jones, that he accidentally left a sponge inside the patient during surgery. He states that he has been under a lot of stress the last two months due to his impending divorce. At a meeting with you and Dr. Jones, Dr. Jones suggests that an operation be conducted to remove the sponge, but he implies that the patient not be told about the sponge following surgery. He implies that he has pulled this off before with another patient and is confident that he will be able to easily fix the problem.
Give a plan of action on how you would handle this situation. What would you do about Dr. Jones suggestion? Why? What would you do about Dr. Manning? What if a claim is filed? Who is potentially liable and what are the possible damages? Back up your answer with the appiicable laws.
(B)You are the Human Resources Director for Hefty Corporation, Inc. Hefty has over 30,000 employees worldwide. Hefty manufactures and sells medical devices. Approximately 30% of its employees are seasonal employees, and another 25% are treated as independent contractors even though they work at Hefty facilities exclusively and must follow all Hefty policies and procedures. You get a memorandum on your desk from the newly hired compliance director stating that I understand that we should review the Employer Shared Responsibility Rules, but I have not had time. Would you please do so, and let me know what changes need to be made?
No updates to employee benefits or the employee manual have been made since 2010, due to a wave of layoffs from 2010 to 2014.
What will you advise? Cite to the applicable provisions of the Affordable Care Act in your answer.
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(C)You are the compliance director for Nursing Home Services, Inc., a privately held company with 200 employees. Nursing Home Services manages 6 nursing homes in the city of Denver, Colorado which facilities provide multiple levels of care, including full nursing services. Many patients have Alzheimers and are not ambulatory. You receive a memorandum on your desk from IT stating we have detected a virus on the network, and unfortunately there has been a breach in the patient portal network. Please take measures to protect the EHR (electronic health records).
What steps do you take? Do you have any reporting responsibilities? Cite to HIPAA and other federal laws which may apply in your answer.
(D)You are the paralegal for a newly formed Accountable Care Organizaton, Getwell Corporation. Getwell has outpatient clinics all over the country, and plans to launch and start advertising its telemedicine services. Getwell also has diagnostic centers in two cities, and has a large Medicare population. The newly formed ACO Board is having its first meeting to discuss payment methods, billing and its brand new telehealth system. Choose two payment reform models covered in this course in Weeks 6 to 9, and argue to the ACO Board that one payment model is preferable to another. Briefly compare and contrast the two models from a legal standpoint by discussing the potential legal risks associated with ONE specific federal or state law-either anti-trust, anti-kickback or tax law (hint one: if you choose tax law, this will be a federal tax law). Discuss how these barriers may be legally overcome (hint two: is there a safe harbor, or is there a way to structure this payment model to reduce legal risks associated with this federal law?) with the payment model which you have recommended to the Board. Cite to the provisions of the ACA and other applicable laws to support why you recommend one model over another.
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