Managing Legal Compliance in the Health Care Industry

Author: George B. Moseley III
Publisher: Jones & Bartlett Publishers
ISBN: 9781449639655
Release Date: 2013-09-20
Genre: Business & Economics

The pressures are mounting for healthcare organizations to comply with a growing number of laws and regulations. With the passage of the Affordable Care Act, sophisticated compliance programs are now mandatory and the penalties for noncompliance are more severe. Increasingly, those who are trained in the fundamentals of healthcare laws and regulations and the complexities of designing and running compliance programs will be in high demand. Managing Legal Compliance in the Health Care Industry is a comprehensive resource that will prepare you to build and manage successful compliance programs for any healthcare service or industry. In three sections, this unique title first examines all the key laws and regulations with which healthcare organizations must comply. In section two, the author explores in detail the seven essential ingredients for a good compliance program. In the final section, the book explains how the compliance program must be adapted to the special needs of different types of healthcare organizations. Designed for administrators and legal counsel in health care organizations, as well graduate-level students in programs of public health, health administration, and law, Managing Legal Compliance in the Health Care Industry is filled with highly practical information about the ways that legal violations occur and how good compliance programs function. Key Features: -Examines in detail the current laws and regulations with which all types of healthcare organizations must comply -Explores the seven essential ingredients for a good compliance program -Looks at compliance programs within twelve different types of healthcare organizations -References real-world cases of fraud and abuse -Includes Study Questions and Learning Experiences in each chapter that are designed to encourage critical thinking -Accompanied by a Navigate Companion Website that offers an interactive glossary, a list of current compliance events, downloadable documents, and a reading list.

Managing Health Care Business Strategy

Author: George B. Moseley III
Publisher: Jones & Bartlett Learning
ISBN: 9781284081107
Release Date: 2017-03-20
Genre: Medical

Managing Health Care Business Strategy is the definitive textbook on strategic planning and management for healthcare organizations. It offers all the basic information on strategic planning and management within the unique context of organizations concerned with the delivery and financing of health care. It does this by noting the singular strategic environment in health care, explaining the special procedures and options available to health care organizations, and providing real-life examples in the form of case studies. It includes not only a description of the basic multi-step process of creating and then managing a strategic plan, but also a detailed look at the role played by the key business functions (finance, marketing, human resources, information technology, and law) as well as specific strategic options (merger/acquisition, reorganization, joint venture) and some of the popular tools for analyzing strategic situations (balanced scorecard, Six Sigma, SWOT).

Patient Care Case Law

Author: George D. Pozgar
Publisher: Jones & Bartlett Publishers
ISBN: 9781449604585
Release Date: 2012-02-27
Genre: Business & Economics

In today’s litigious environment, where high-stakes negligence suits plague the health care industry, it is imperative that health care professionals understand their rights and responsibilities under the law and the legal ramifications of their actions. Patient Care Case Law: Ethics, Regulation, and Compliance is a unique compendium of case studies that provides a foundation for that understanding. The broad variety of case studies covered in this reference is organized around the patient’s progression through the health system, from admission to discharge. The text features chapters on patient rights, the screening and assessment process, diagnosis, treatment, universal protocols, discharge planning, and follow-up care. Additionally, chapters on employee and patient safety, human resources, and criminal acts round out the content. Each legal case presented includes a review of the facts, the issues related to the health care industry, and the court’s ruling and rationale for its decision. Patient Care Case Law: Ethics, Regulation, and Compliance features: • Appendices on the U.S. Code of Federal Regulations Chapter 42 for hospitals, Medicare/Medicaid certification, and assessment of quality care • A summary case written as a “closet drama” • Discussion questions for each case presented • Descriptive citations providing useful additional information • A list of suggested websites to aid further research • Accompanying resources for instructors: TestBank and PowerPoints

Essentials of Healthcare Compliance

Author: Shelley C Safian
Publisher: Cengage Learning
ISBN: 9781111799441
Release Date: 2009-01-13
Genre: Medical

Essentials of Health Care Compliance provides you with the knowledge and skills necessary to understand how a formal compliance program is implemented at a health care facility. Managing several staff members and keeping a health care practice compliant with federal, state, and local statutes and regulations is a challenging job. Real-world examples and the author's hands-on approach will help you visualize yourself on-the-job, using the knowledge you have gained from this book to meet these challenges. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version.

Healthcare Information Privacy and Security

Author: Bernard Peter Robichau
Publisher: Apress
ISBN: 9781430266778
Release Date: 2014-06-23
Genre: Computers

Healthcare IT is the growth industry right now, and the need for guidance in regard to privacy and security is huge. Why? With new federal incentives and penalties tied to the HITECH Act, HIPAA, and the implementation of Electronic Health Record (EHR) systems, medical practices and healthcare systems are implementing new software at breakneck speed. Yet privacy and security considerations are often an afterthought, putting healthcare organizations at risk of fines and damage to their reputations. Healthcare Information Privacy and Security: Regulatory Compliance and Data Security in the Age of Electronic Health Records outlines the new regulatory regime, and it also provides IT professionals with the processes and protocols, standards, and governance tools they need to maintain a secure and legal environment for data and records. It’s a concrete resource that will help you understand the issues affecting the law and regulatory compliance, privacy, and security in the enterprise. As healthcare IT security expert Bernard Peter Robichau II shows, the success of a privacy and security initiative lies not just in proper planning but also in identifying who will own the implementation and maintain technologies and processes. From executive sponsors to system analysts and administrators, a properly designed security program requires that that the right people are assigned to the right tasks and have the tools they need. Robichau explains how to design and implement that program with an eye toward long-term success. Putting processes and systems in place is, of course, only the start. Robichau also shows how to manage your security program and maintain operational support including ongoing maintenance and policy updates. (Because regulations never sleep!) This book will help you devise solutions that include: Identity and access management systems Proper application design Physical and environmental safeguards Systemwide and client-based security configurations Safeguards for patient data Training and auditing procedures Governance and policy administration Healthcare Information Privacy and Security is the definitive guide to help you through the process of maintaining privacy and security in the healthcare industry. It will help you keep health information safe, and it will help keep your organization—whether local clinic or major hospital system—on the right side of the law.

Healthcare Fraud

Author: Rebecca S. Busch
Publisher: John Wiley & Sons
ISBN: 9781118240250
Release Date: 2012-03-23
Genre: Business & Economics

An invaluable tool equipping healthcare professionals, auditors, and investigators to detect every kind of healthcare fraud According to private and public estimates, billions of dollars are lost per hour to healthcare waste, fraud, and abuse. A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud, Second Edition provides tips and techniques to help you spot—and prevent—the "red flags" of fraudulent activity within your organization. Eminently readable, it is your "go-to" resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations. Includes new chapters on primary healthcare, secondary healthcare, information/data management and privacy, damages/risk management, and transparency Offers comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans Examines the necessary background that internal auditors should have when auditing healthcare activities Managing the risks in healthcare fraud requires an understanding of how the healthcare system works and where the key risk areas are. With health records now all being converted to electronic form, the key risk areas and audit process are changing. Read Healthcare Fraud, Second Edition and get the valuable guidance you need to help combat this critical problem.

The Stark Law Explained

Author: Daniel Melvin
Publisher: Createspace Independent Publishing Platform
ISBN: 149743758X
Release Date: 2016-06-24
Genre:

The riddles of the Stark Law have become increasingly difficult to solve. Thousands of pages of agency discussion and interpretation, judicial decisions, government and defense briefs, and commentary have tried to decode those riddles. The product of years of research and hands-on legal practice, this book provides a comprehensive and in-depth Stark Law resource that will give readers working in or with the health care industry the keys to decode this riddle, including: executives administrators attorneys compliance professionals clinicians accountants valuators business consultants regulators The main body of the book avoids "legalese" to explain the law in plain English. A Glossary of Acronyms is also included for readers new to the area. Much more than a primer, however, the book also provides detailed discussion and analysis for the reader looking for a more nuanced and comprehensive treatment. This book is both a teaching tool and reference guide to one of the most important, and complicated, statutes in the current environment of increased government scrutiny of health care regulatory compliance.

Legal and Ethical Aspects of Health Information Management

Author: Dana C. McWay
Publisher: Cengage Learning
ISBN: 9781305686328
Release Date: 2015-01-10
Genre: Medical

Understanding the complex legal and ethical principles that govern health information management is more important than ever. To help you successfully navigate these legal issues, LEGAL AND ETHICAL ASPECTS OF HEALTH INFORMATION MANAGEMENT is revised, updated, and expanded, providing the opportunity to focus on law and ethics as they relate to HIM. Key topics include the role of social media in health care, expansion of existing materials on e-discovery, compliance, completeness of the health record, breaches of confidentiality, and much more. Features include enrichment activities, mapping to CAHIIM standards, and interactive quizzing and case studies to help develop practical application and high-level problem solving skills. Written by a seasoned HIM professional and lawyer, LEGAL AND ETHICAL ASPECTS OF HEALTH INFORMATION MANAGEMENT, 4th Edition provides a complete solution for understanding the legal and ethical concerns that safeguard health care information today. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version.

Managing Relationships with Industry

Author: Steven C. Schachter
Publisher: Academic Press
ISBN: 9780080559551
Release Date: 2010-07-28
Genre: Psychology

Now more than ever, doctors are being targeted by government prosecutors and whistleblowers challenging the legality of their relationships with drug and device companies. With reputations at stake and the risk of civil and criminal liability, it is incumbent upon doctors to protect themselves. Managing Relationships with Industry: A Physician’s Compliance Manual is an indispensable resource for doctors, professional societies, academic medical centers, community hospitals, and group practices struggling to understand the ever changing law and ethical standards on interactions with pharmaceutical and device companies. It is the first comprehensive summary of the law and ethics on physician relationships with industry written for the physician. Authored by a former state Attorney General, Harvard Medical School Professor, health care lawyer and professor of ethics, Managing Relationships approaches the topic from a balanced and reasoned perspective adding to the on-going national dialogue and debate on the proper limits to medicine’s relationship with industry. The first complete and up-to-date summary and analysis of the law and ethics on physician-industry relationships Focuses on major enforcement actions and whistleblower lawsuits and the lessons learned for physicians Provides options and guidance for maintaining compliant relationships and avoiding traps for the unwary Covers both drug and device company relationships Summarizes the types of industry relationships that are necessary and productive and those that are harmful and abusive Details the law and ethics for each type of relationship including gifts, off-label uses and marketing, CME, speaker’s bureaus, free samples, grants, consulting arrangements, etc. Includes sample contracts for permissible consulting and CME speaker engagements

Encyclopedia of Health Care Management

Author: Michael J. Stahl
Publisher: SAGE Publications
ISBN: 9781452265247
Release Date: 2003-10-21
Genre: Medical

The topic of health care management has escalated to one of the most widely discussed and debated topics in the health care industry, MBA programs, and in the field of medicine in general. In the 1980s, the industry was relatively stable and the need for combining business acumen with medicine was less than today. However, as we enter the 21st century, the need for applying business and management skills to the health care industry is stronger than ever. This Encyclopedia covers every topic a medical professional, institutional administrator, or MBA student would need to know about the business of health care. Key Features * Over 600 entries * More than 160 expert contributors from the fields of medicine, public health, business * Tables on medical degrees, medical specialties, medical organizations, health care acronyms, medical legislation * Unites the business and medical worlds, and spans the academic, corporate, and governmental arenas Topics Covered Accounting and Activity-Based Costing / Economics / Finance / Health Policy / Human Resources / Information Technology / Institutions and Organizations / International Health Care Issues / Legal and Regulatory Issues / Managed Care / Marketing and Customer Value / Operations and Decision Making / Pharmaceuticals and Clinical Trials / Quality / Statistics and Data Mining / Strategy

Healthcare Hazard Control and Safety Management Third Edition

Author: James T. Tweedy
Publisher: CRC Press
ISBN: 9781482206562
Release Date: 2014-03-12
Genre: Business & Economics

Comprehensive in scope, this totally revamped edition of a bestseller is the ideal desk reference for anyone tasked with hazard control and safety management in the healthcare industry. Presented in an easy-to-read format, Healthcare Hazard Control and Safety Management, Third Edition examines hazard control and safety management as proactive functions of an organization. Like its popular predecessors, the book supplies a complete overview of hazard control, safety management, compliance, standards, and accreditation in the healthcare industry. This edition includes new information on leadership, performance improvement, risk management, organizational culture, behavioral safety, root cause analysis, and recent OSHA and Joint Commission Emergency Management requirements and regulatory changes. The book illustrates valuable insights and lessons learned by author James T. Tweedy, executive director of the International Board for Certification of Safety Managers. In the text, Mr. Tweedy touches on the key concepts related to safety management that all healthcare leaders need to understand. Identifies common factors that are often precursors to accidents in the healthcare industry Examines the latest OSHA and Joint Commission Emergency Management Requirements and Standards Covers facility safety, patient safety, hazardous substance safety, imaging and radiation safety, infection control and prevention, and fire safety management Includes references to helpful information from federal agencies, standards organizations, and voluntary associations Outlining a proactive hazard control approach based on leadership involvement, the book identifies the organizational factors that support accident prevention. It also examines organizational dynamics and supplies tips for improving organizational knowledge management. Complete with accompanying checklists and sample management plans that readers can immediately put to use, this text is currently the primary study reference for the Certified Healthcare Safety Professional Examination.

Principles of Health Care Management

Author: Professor Emeritus School of Public Health and Health Sciences University of Massachusetts Amherst Massachusetts Seth B Goldsmith, SCD, JD
Publisher: Jones & Bartlett Publishers
ISBN: 9781449610456
Release Date: 2010-10-25
Genre: Law

Faced with strict government regulations and increasing service demands by consumers, healthcare providers find themselves accountable on both ends. Written to reflect the realities of the 21st century, Principles of Health Care Management considers the many outside forces influencing health care institutions, and in doing so provides a progressive and modern reference on how to effectively manage a health organization. Using relevant case studies to illustrate key points, this text explains the critical changes and challenges that administrators must deal with as they go about practicing their profession and what students must learn as they begin their study of this vital field.

Compliance Management A How to Guide for Executives Lawyers and Other Compliance Professionals

Author: Nitish Singh Ph.D.
Publisher: ABC-CLIO
ISBN: 9781440833120
Release Date: 2015-03-10
Genre: Business & Economics

This practical guide shows how to build an effective compliance and ethics program that will lower a business's risks and improve productivity. • Offers a step-by-step guide to creating and managing an effective compliance program • Showcases the latest best practices in a world of ever-changing regulations • Identifies the importance of developing and maintaining a corporate culture of "doing the right thing" and shows how ethical training can improve compliance • Features interviews with and best practices from top compliance executives, judges, Department of Justice attorneys, and Archer Daniels Midland informant Mark Whitacre • Provides easy-to-understand overviews and recommendations for complying with specific laws

Essentials of Physician Practice Management

Author: Blair A. Keagy
Publisher: John Wiley & Sons
ISBN: 9781118429327
Release Date: 2012-06-14
Genre: Medical

Essentials of Physician Practice Management offers a practical reference for administrators and medical directors and provides a comprehensive text for those preparing for a career in medical administration, practice management, and health plan administration. Essentials of Physician Practice Management is filled with valuable insights into every aspect of medical practice management including operations, financial management, strategic planning, regulation and risk management, human resources, and community relations.