Health Law

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

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ISBN: 9780314064578 | 0314064575
Cover: Hardcover
Copyright: 3/1/1996

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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.

Preface

Westlaw Overview

vii

Regulation of Health Care Institutions

(38)

Taxonomy of Health Care Institutions

(4)

Private Accreditation and Public Quality Control Regulation

(6)

State and Federal Authority to Regulate

(1)

Establishing Regulatory Standards

(2)

Substantive Review of Standards

(1)

Specific Federal Regulatory Standards

(4)

Enforcement

(8)

Health Planning and Certificate of Need

(9)

Hospital Rate Regulation

(1)

Federal Tax Exemption of Health Care Institutions

(16)

Tax--Exempt Purposes

(3)

Competitive Business Strategies

(5)

Tax Exemption of Alternative Delivery Systems

(5)

Conclusion

(1)

Regulation and Licensure of Health Care Professionals

(36)

Entry Requirements

(1)

Unauthorized Practice

(8)

Scope of Practice

(4)

Discipline

(6)

Substantive Grounds for Discipline

(9)

The Medicare Utilization and Quality Control Peer Review Organization Program

(5)

Professional Relationships in the Health Care Enterprise

(69)

Staff Privileges

(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

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Health Law

Summary

Table of Contents

Supplemental Materials