Posted: September 3rd, 2015

Law that interprets the U.S. constitution and relates to issues in health care.

 

1. The object of this conference is for you to get a feel for finding case law that interprets the U.S. constitution and relates to issues in health care. Use the web or any other resources and identify a U.S. Supreme Court case that dealt with a health care related issue.  Once you have identified a case, provide the case name and then discuss it generally, what was it about, what were the issues at stake and any other information you think may be interesting to your classmates.
2. Practically half, if not more, of the organizations within the U.S. health care system are 501(c)(3) organizations. First, explain briefly what a 501(c)(3) organization is. Second, identify a health care organization that is a 501(c)(3) and discuss what it is, what it does and any other information that might be of interest to your class mates.
3. Identify a health care related bill that is pending in a state legislature and discuss its content.  Make sure you attach a copy of the bill to your post.

 

Part 2 (2 pages)

 

1.The most important element in a claim of negligence is that the defendant owed some “Duty of Care” to the plaintiff? Discuss what standards are used to determine a health care provider‘s Duty of Care or Describe a Duty of Care owed by a health care provider.

 

2. Respondeat Superior/Vicarious Liability are legal doctrines that hold an employer liable for the acts of its employees in certain circumstances. Identify a published court decision/case that discussed a matter in which a health care employer was either held liable or not held liable for the acts of its employee?

 

3. Torts are a civil wrong for which the courts can provide a remedy? Pick one of the torts described in your text and describe the elements of it.

 

Part 3 (2 pages)

1. How are contracts utilized in the health care system?Health care organizations regularly enter into contracts with insurance companies, vendors, other organizations, property owners, the federal, state and local governments, etc.Explain any type of contract that a health care organization might enter into and briefly discuss its purpose in the health care system.
2. Contracts are basically agreements between certain parties that are enforceable by a court or at law.In what circumstances will a court not enforce a contract? Hint:  What might a defense to a lawsuit to enforce a contract be?
3. Actions for I’m a Freelancer…What does it mean to be an “independent contractor”? Are there rules for whether or not someone can be considered an independent contractor?

 

Part 4 (2 pages)

1. Other than the Federal HMO Act, most regulation of Managed Care Organizations (MCOs) is done by state health and insurance departments.  Identify one (1) state regulation (not a statute) that affects an MCO and describe its purpose, i.e. what does it do, require, proscribe, etc.
2. The Sherman Anti-Trust Act has been invoked in many health care-related matters. Identify and describe one (1) way in which the Act affects the health care industry.
3. The Medicare program has had a managed care component (Part C) for some time. Medicare Advantage is the current name for the program. Describe one (1) regulatory requirement that the Federal government has promulgated for insurance carriers that provide a Medicare managed care plan.

Part 5 (2 pages)

1. A major controversy in health care today is whether health care organization leaders should be held personally and/or criminally responsible for fraudulent billing that occurs within their organizations. Do you think health care organization leaders should be subject to criminal prosecution for improper billing of Medicare and Medicaid? Why or Why not? Under what circumstances?
2. Your text book provides a comprehensive look at physician negligence and physician misconduct issues. Find one of the issues online and discussin this paper.
3. How has HIPPA enhanced patient privacy, if at all? Can you find a court case involving inappropriate disclosure of health information?

Part 6 (2 pages)

1. What does it mean to have “privileges” at a hospital? Can you find a court case the dealt with an issue relating to a physician’s privileges?
2. Explain the duty to warn third parties? Can you find a case involving the duty?
3. What is mental health parity in the health plan context? Can you describe changes that have occurred in the last 10 years or so?

Part 7 (2 pages)

1. In most jurisdictions in the U.S. there is a legal standard used to determine whether the courts will uphold a regulatory decision or a decisions of an administrative law judge. The standard is based upon whether or not the court found the administrative decision to be “arbitrary and capricious”. Can you find and discuss a court case where the standard was used to review an administrative decision relating to health care? Remember an administrative decision is a decision by a government agency.
2. U.S. Federal government agencies generally publish proposed regulations before the implement them. They are published in the Federal Register. Can you find a proposed regulation relating to health care and discuss what the purpose and policy of that regulation is?
3. Identify a state agency that is involved in health care and provide its name and describe its purpose. What are the differences between the agency you found and an agency that one of your peers found? Are there different agencies in different states that have varying authority and scope?

Part 8 (2 pages)

1. Describe something protected by patient’s rights regulation?

 

2. Describe and discuss what each of these terms mean? Can you find a case that argued any of these theories?

 

3. What do you think informed consent is?  Can you find a state that has an informed consent statute and describe what it requires?

 

Part 9 (2 pages)

 

1. Discuss the types of injuries normally reported to law enforcement as they occur in a health care institution or are treated in a facility after taking place outside. Does this not conflict with patient privacy expectations?

 

2. There are many statues and regulations that prohibit fraud in federal and state health care benefit programs.  Find a law or regulation and discuss its contents or find a case that addresses fraud in health care and discuss the finding of the case.

 

3. What types of databases or information is there available to employers to check up on the conduct of professionals?

 

Part 10 (2 pages)

 

1. Provide an example of a historical event that either led to or enhanced the development of health care ethics.

 

2. What is medical futility? Can you find a case, statute or regulation that deals with the issue of medical futility?

 

3. Describe an ethical issue that has arisen now that science has mapped the human genome?

 

 

 

 

 

Part 11 (2 pages)

 

1. Describe one right protected by the NLRA, can you find a case the addresses that right in the health care industry?

 

2. OSHA has many specific standards that are applicable to the health care industry, find one and discuss it.

 

3. What are whistleblowers? How are they protected under the law (hint: there are lots of different laws that protect them in different ways)? What are some of the drawbacks to becoming a whistleblower?

 

Part 12 (2 pages)

 

1. The Emergency Treatment and Active Labor Act was enacted years ago to protect indigent patients in emergency rooms.  Can you find a case dealing with EMTALA? How did it turn out?

 

2. What is the locality rule, can you find a case dealing with it?

 

3. Other than the locality rule, what are some of the other ways the standard of care is determined in medical malpractice cases?

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