Health Law

by Furrow, Barry R.; Greaney, Thomas L.; Johnson, Sandra H.; Jost, Timothy Stoltzfus; Schwartz, Robert L.

• ISBN13: 9780314064578
• ISBN10: 0314064575
• Format: Hardcover
• Copyright: 1996-03-01
• Publisher: West Group

Summary

Regulation of Health Care Institutions; Federal Tax Exemption of Health Care Institutions; Regulation and Licensure of Health Care Professionals; Professional Relationships in the Health Care Enterprise; Health Care Business Associations; Liability of Health Care Professionals; Liability of Health Care Institutions; Liability of Managed Care Organizations; Reforming the Tort System for Medical Injuries; Antitrust Law; Regulation of Private Health Care Financing; Obligations to Provide Medical Care; Medicare; Medicaid; Medicare and Medicaid Fraud and Abuse; Definitions of Death; Making Decisions About Death and Dying; Limitations on Reproduction; Sterilization and Contraception; Wrongful Birth, Wrongful Life and Wrongful Conception; Abortion; Potential Fetal-Maternal Conflicts; Assisted Conception; Regulation of Research Upon Human Subjects; Health Care Reform.

Table of Contents

Preface	v
Westlaw Overview	vii
Regulation of Health Care Institutions	1	(38)
Taxonomy of Health Care Institutions	3	(4)
Private Accreditation and Public Quality Control Regulation	7	(6)
State and Federal Authority to Regulate	13	(1)
Establishing Regulatory Standards	14	(2)
Substantive Review of Standards	16	(1)
Specific Federal Regulatory Standards	17	(4)
Enforcement	21	(8)
Health Planning and Certificate of Need	29	(9)
Hospital Rate Regulation	38	(1)
Federal Tax Exemption of Health Care Institutions	39	(16)
Tax--Exempt Purposes	41	(3)
Competitive Business Strategies	44	(5)
Tax Exemption of Alternative Delivery Systems	49	(5)
Conclusion	54	(1)
Regulation and Licensure of Health Care Professionals	55	(36)
Entry Requirements	58	(1)
Unauthorized Practice	59	(8)
Scope of Practice	67	(4)
Discipline	71	(6)
Substantive Grounds for Discipline	77	(9)
The Medicare Utilization and Quality Control Peer Review Organization Program	86	(5)
Professional Relationships in the Health Care Enterprise	91	(69)
Staff Privileges	92	(10)
Physician-Hospital Contracts for Physician Services	102	(6)
Employment-at-Will	108	(2)
National Labor Relations Act	110	(2)
Anti-Discrimination Statutes	112	(13)
Quality Assurance and Risk Management	125	(14)
Medical Information and Records: Confidentiality and Disclosure	139	(21)
Health Care Business Associations	160	(72)
For--Profit Corporations	162	(27)
Not--for--Profit Corporations	189	(11)
Professional Corporations	200	(7)
Partnerships	207	(9)
Limited Liability Companies	216	(4)
Structuring Health Care Enterprises	220	(12)
The Liability of Health Care Professionals	232	(57)
Physician Liability for Patient Injury	233	(32)
Physician Obligations to Obtain a Patient's Informed Consent	265	(24)
The Liability of Health Care Institutions	289	(19)
Liability of Managed Care Organizations	308	(24)
Reforming the Tort System for Medical Injuries	332	(32)
Antitrust Law	364	(134)
Statutes and Interpretative Principles	367	(15)
Professionalism and Competition	382	(16)
Physician--Hospital Relationships	398	(38)
Health Care Financing: Relationships Between Providers and Payers	436	(25)
Relationships Among Hospitals and Other Health Facilities	461	(32)
Sales of Health Care Commodities	493	(5)
Regulation of Private Health Care Financing	498	(38)
Regulation of Private Insurance	498	(17)
The Employee Retirement Income Security Act of 1974 (ERISA) and Health Benefits	515	(10)
Regulation of Managed Care	525	(11)
Obligations to Provide Medical Care	536	(24)
Emergency Medical Treatment and Labor Act	539	(10)
Obligations to Provide Emergency Care Under State law	549	(2)
Obligations Under the Hill--Burton Act	551	(2)
Nondiscrimination Obligations Under Title VI	553	(2)
Discrimination Against Persons Based on Medical Condition	555	(3)
Conclusion	558	(2)
Medicare	560	(43)
Authority and Administration	562	(2)
Eligibility	564	(1)
Covered and Excluded Services	565	(5)
Provider Participation	570	(4)
Medicare Prospective Payment Under Diagnosis--Related Groups	574	(6)
Cost-Based Reimbursement	580	(1)
Medicare Part B Payment	581	(8)
Billing and Claims	589	(3)
Medicare Managed Care	592	(3)
Administrative Appeals and Judicial Review of Medicare Determinations	595	(7)
The Medicare as Secondary Payer Program	602	(1)
Medicaid	603	(34)
Introduction	604	(1)
Eligibility	605	(12)
Benefits	617	(6)
Medicaid Payment for Services	623	(5)
Medicaid Managed Care	628	(3)
Administration	631	(1)
Federal and State Medicaid Funding	632	(1)
Medicaid Appeals and Judicial Review	632	(5)
Medicare and Medicaid Fraud and Abuse	637	(35)
Introduction	638	(2)
False Claims and Statements	640	(4)
Bribes, Kickbacks, and Much Else	644	(10)
Self-Referrals	654	(6)
Civil Penalties and Exclusions	660	(8)
Investigations by the office of Inspector General	668	(1)
State Medicaid Fraud and Abuse Laws	669	(3)
Definitions of Death	672	(10)
Making Decisions About Death and Dying	682	(89)
Introduction---The Right to Forgo Life Sustaining Treatment	685	(12)
Traditionally Recognized Significant State Interests That Limit the Judicially Recognized Right to Forgo Life Sustaining Treatment	697	(4)
Determining Decisional Capacity or Competency of Patients for Whom Life Sustaining Medical Treatment Is Appropriate	701	(3)
The Right to Forgo Life Sustaining Treatment and Competent Adults	704	(2)
The Right to Forgo Life Sustaining Treatment and Incompetent Adults	706	(19)
The Right to Forgo Life Sustaining Treatment and Children	725	(11)
Religion and the Right to Forgo Life Sustaining Treatment	736	(7)
Judicial Process in Cases Involving Decisions to Forgo Life Sustaining Treatment	743	(6)
Civil Liability for Failing to Recognize a Decision to Forgo Life Sustaining Treatment	749	(2)
Homicide Liability and the Decision to Forgo Life Sustaining Treatment	751	(4)
Euthanasia and Suicide	755	(6)
Special Issues in Terminating Particular Kinds of Life Sustaining Treatment	761	(7)
The Patient Self-Determination Act	768	(3)
Limitations on Reproduction: Sterilization and Contraception	771	(9)
Sterilization	771	(5)
Other Forms of Contraception	776	(4)
Wrongful Birth, Wrongful Life and Wrongful Conception	780	(13)
Abortion	793	(16)
The Constitutional Framework	795	(5)
Particular Limitations and Restrictions on Abortion	800	(9)
Potential Fetal--Maternal Conflicts	809	(12)
Assisted Conception	821	(18)
Regulation of Research Upon Human Subjects	839	(12)
Health Care Reform	851	(14)
Appendix: Researching Health Law on Westlaw	865	(16)
Table of Cases	881	(30)
Table of Statutes	911	(34)
Index	945