Problems in Health Care Law

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ISBN: 9780763745554 | 0763745553
Cover: Paperback
Copyright: 1/26/2006

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This classic text has been extensively updated and restructured to use the "problems" approach which analyzes underlying, conflicting public policies And The legal solutions for those problems. it continues to be the helpful one-volume overview of healthcare law that it and its predecessor, Problems in Hospital Law, have been since 1968. Topics covered include: organizational, physical, and staffing resources; relationships with patients including both medical decision-making issues And The handling of medical information; financing of health care services; and liability issues.

Preface

Acknowledgments

CHAPTER ONE Introduction to the American Legal System

(28)

1-1 The Nature of the Law

(1)

1-2 Governmental Organization and Functions

(2)

1-3 Sources of Law

(9)

1-4 Organization of the Court System

(8)

1-5 Contracts

(7)

CHAPTER TWO Organization of the Health Care Delivery System

(64)

2-1 What Are the Key Characteristics of the Six Types of Organizations?

(13)

2-2 How Are Governing Bodies Selected and What Is Their Role and Responsibility?

(13)

2-3 How Are CEOs Selected and What Is Their Role and Responsibility?

(8)

2-4 What Are the Licensing and Accreditation Requirements for Health Care Organizations?

(9)

2-5 What Are the Issues When an Organization Is Converted from One Type into Another?

(5)

2-6 What Are the Issues When an Organization Is Merged, Consolidated, Sold, or Dissolved?

(4)

2-7 What Are the Issues When an Organization Closes or Relocates a Hospital or Other Delivery Location?

(3)

2-8 What Is the Impact of Bankruptcy Law?

(7)

CHAPTER THREE Creation and Maintenance of Physical Resources

(28)

3-1 What Land Use, Construction, and Other Permitting Regulations Are Applicable to Health Care Facilities?

(7)

3-2 What Are the Licensure Requirements for Health Care Facilities?

101

(1)

3-3 What Are the Regulations Concerning the Manufacture and Use of Drugs, Medical Devices, Tissues, and Other Items Used in Health Care?

102

(19)

CHAPTER FOUR Individual Providers and Caregivers

121

(92)

4-1 Individual Licensing

122

(15)

4-2 Private Certification of Individuals

137

(2)

4-3 Employment Relationship

139

(66)

4-4 Independent Contractors

205

(2)

4-5 Others Who Provide Services in Health Care Organizations

207

(6)

CHAPTER FIVE Medical Staff

213

(66)

5-1 The Organization and Role of the Medical Staff

214

(12)

5-2 Appointment to the Medical Staff

226

(11)

5-3 Delineation of Clinical Privileges

237

(2)

5-4 Periodic Review and Reappointment

239

(4)

5-5 Modification and Termination of Privileges

243

(8)

5-6 Review Procedures for Adverse Actions

251

(13)

5-7 Potential Liability of Those Involved in the Process of Making Medical Staff Appointment and Clinical Privilege Decisions

264

(6)

5-8 Relationship with Physicians Outside the Medical Staff Relationship

270

(9)

CHAPTER SIX Relationship of Patient and Provider

279

(36)

6-1 How Does a Relationship with a Physician Begin?

280

(3)

6-2 How Does a Relationship with a Hospital Begin?

283

(4)

6-3 What Are the Special Rules Concerning Emergency Cases?

287

(6)

6-4 What Are the Effects of Nondiscrimination Laws?

293

(5)

6-5 How Does a Relationship with a Physician End?

298

(3)

6-6 How Does a Relationship with a Hospital End?

301

(14)

CHAPTER SEVEN Decision-making Concerning Individuals

315

(106)

7-1 Who Is the Appropriate Decisionmaker?

316

(23)

7-2 What Information Needs to Be Given to the Decisionmaker?

339

(18)

7-3 Who Has the Responsibility to Provide Information?

357

(2)

7-4 What Should Be Done to Prove the Decision?

359

(8)

7-5 What Constitutes Coercion That Makes Consent Involuntary and Invalid?

367

(1)

7-6 What Limits Are Placed on the Permitted Range of Decisions?

368

(21)

7-7 When Can the Law Authorize Involuntary Treatment?

389

(15)

7-8 What Are the Consequences of Stopping Treatment or Providing Unauthorized Treatment?

404

(17)

CHAPTER EIGHT Health Care Information

421

(72)

8-1 What Are the Underlying Issues Addressed Through the Laws Concerning Health Care Information?

428

(1)

8-2 Who Owns Medical Records?

429

(2)

8-3 What Records Must Be Created, and How Must They Be Maintained?

431

(8)

8-4 What Are the Laws Concerning Privacy of Health Care Information?

439

(13)

8-5 What Are the Laws Concerning Use of Health Care Information?

452

(3)

8-6 What Are the Laws Concerning Disclosure of Health Care Information?

455

(28)

8-7 What Legal Issues Flow from the Use of Audio and Video Transmissions and Recordings?

483

(3)

8-8 What Legal Issues Flow from the Use of Computers and the Internet?

486

(7)

CHAPTER NINE Paying for Health Care Resources and Services

493

(66)

9-1 What Attempts Have Been Made to Directly Address Provider Charges and Budgets?

495

(4)

9-2 How Are Medicare, Medicaid, and Other Major Government Payment Programs Structured?

499

(22)

9-3 How Are Employer-Sponsored and Other Private Payment Programs Structured?

521

(6)

9-4 What Are the Laws Governing Collection of Copayments, Deductibles, and Uninsured Amounts?

527

(12)

9-5 How Can Capital Financing Be Arranged?

539

(4)

9-6 What Are the Other Sources of Financing for Providers?

543

(1)

9-7 What Is the Impact of Tax Structure on the Health Care System?

544

(15)

CHAPTER TEN Third-party Health Care Coverage

559

(22)

10-1 Who Is Covered by the Plan?

559

(3)

10-2 How Is Utilization Managed?

562

(20)

10-3 What Are the Appeal Rights from Adverse Utilization Determinations?

582

(1)

10-4 When Can Third-party Payers Be Liable for the Consequences of Their Decisions?

583

CHAPTER ELEVEN Civil Liability

581

(100)

11-1 What Must Be Proved to Establish Liability for Negligence Torts?

588

(17)

11-2 What Are Intentional Torts, and How Do They Differ from Negligent Torts?

605

(6)

11-3 What Are the Major Defenses to Liability Suits for Torts?

611

(11)

11-4 What Are the Special Strict Liability Rules for Products Liability?

622

(3)

11-5 Who Is Responsible for Paying for Liability?

625

(8)

11-6 What Types of Insurance Are Available?

633

(2)

11-7 What Are Some of the Ways That Have Been Proposed and/or Implemented to Deal with the Periodic Malpractice Crisis?

635

(15)

11-8 What Are Some Examples of the Tort Liability of Health Care Providers?

650

(31)

CHAPTER TWELVE Criminal Law and Civil Penalties

681

(28)

12-1 Compliance Programs

682

(1)

12-2 Enforcement Agencies

682

(4)

12-3 Differences Between Criminal and Civil Penalties

686

(16)

12-4 Criminal Law 688 12-5 Suspension, Recoupment, and Exclusion from Federal Programs

702

(1)

12-6 Civil Money Penalties

703

(1)

12-7 Private Lawsuits

704

(5)

CHAPTER THIRTEEN Antitrust

709

13-1 Sherman Antitrust Act

711

(13)

13-2 Clayton Act

724

(6)

13-3 Federal Trade Commission Act

730

(1)

13-4 Exemptions

731

CHAPTER FOURTEEN Reproductive Issues

131

(34)

14-1 Contraception

737

(4)

14-2 Sterilization

741

(5)

14-3 Assisted Conception

746

(8)

14-4 Abortion

754

(6)

14-5 Wrongful Conception, Wrongful Birth, and Wrongful Life Suits

760

CHAPTER FIFTEEN Death and Dead Bodies

165

(624)

15-1 What Is the Definition of Death, and Who May Declare Death?

766

(4)

15-2 What Are the Rules Concerning Handling Dead Bodies?

770

(5)

15-3 When May an Autopsy Be Performed, and What Limits Are There on the Scope of Autopsies?

775

(4)

15-4 What Are the Rules Concerning Donation of Bodies and Body Parts?

779

(10)

Index to Defined Acronyms

789

(4)

Introduction to Index of Cases

793

(2)

Index of Cases

795

(46)

Index of Constitutions, Statutes, Regulations, and Other Materials

841

(14)

Index

855

(44)

About the Authors

899

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Problems in Health Care Law

Summary

Table of Contents

Supplemental Materials