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U.S. health law and policy 2001 : a guide to the current literature / Donald H. Caldwell, Jr.

Title: U.S. health law and policy 2001 : a guide to the current literature / Donald H. Caldwell, Jr.
Author: Caldwell, Donald H. (Donald Harrison), 1959-
Publication: San Francisco : Jossey-Bass : Chicago : Health Forum Inc., c2001.

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Request for On-site Use Request Scan How do I pick up this item and when will it be ready?	Text	Request in advance	KF3821.A1 C35 2001	Off-site

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Details

Additional Authors

American Health Lawyers Association

Description

xxi, 593 p.; 29 cm.

Series Statement

Jossey-Bass/AHA Press series

Uniform Title

Jossey-Bass/AHA Press series

Alternative Title

US health law and policy 2001
United States health law and policy, 2001
US health law and policy, 2001

Subject

Genre/Form

Abstracts
Resource Guide
Bibliography
Bibliographies

Bibliography (note)

Includes bibliographical references and indexes.

Processing Action (note)

committed to retain

Contents

Part 1 Medical Facilities and Organizations -- Chapter 1 An Overview of Health Law 3 -- Chapter 2 Health Care Facilities and Settings 13 -- 2.01 In General 13 -- 2.02 Hospitals 16 -- (1) In General 16 -- (2) Rural Hospitals 23 -- (3) Academic Medical Centers 24 -- (4) Religious Medical Institutions 26 -- 2.03 Nursing Homes 27 -- 2.04 Medical Offices 37 -- 2.05 Home Health Care 38 -- 2.06 Assisted Living Facilities 41 -- 2.07 Hospices 41 -- Chapter 3 Managed Care Organizations 43 -- 3.01 The Health Maintenance Organization (HMO) Model of Care 46 -- 3.02 HMO Model Types 51 -- 3.03 State Regulation of HMOs 53 -- 3.04 Point-of-Service (POS) Product Regulation 55 -- 3.05 Other State Laws 55 -- (1) State Insurance Laws 56 -- (2) Coordination of Benefits 56 -- (3) Certificate-of-Need Laws 56 -- (4) State Rate-Setting Laws 56 -- (5) Any-Willing-Provider Laws 56 -- (6) Small-Group Insurance Reform 56 -- 3.06 Federal Qualification 57 -- 3.07 Government Reimbursement Programs 57 -- (1) Products for Medicare Beneficiaries 57 -- (2) Medicaid Contracting 59 -- (3) The Federal Employees Health Benefit Program (FEHBP) 60 -- (4) State Government 60 -- 3.08 HMO Management and Operational Issues 60 -- (1) Internal Organization and Controls 60 -- (2) Employer Agreements 62 -- (3) Provider Relationships 62 -- (a) Provider Credentialing 62 -- (b) Provider Contracts -- Compensation Arrangements 63 -- (c) Provider Contracts -- Nonrate Issues 64 -- (d) HMO Liability for Provider Malpractice 65 -- (e) Rate Setting and Financial Strategy 65 -- 3.09 Mergers and Closures 66 -- 3.10 HMO Grievance Procedures 66 -- 3.11 Preferred Provider Organizations (PPOs) 68 -- Chapter 4 Integrated Delivery Systems 69 -- 4.02 Advantages and Disadvantages of Integration 86 -- (1) Potential Barriers to Integration 86 -- (2) Financial Issues 86 -- (3) Structure and Degree of Integration 87 -- 4.03 Common Legal Issues 88 -- 4.04 Particular Network Issues 90 -- (1) Acquisition of Physician Practices 91 -- (2) Types of Acquisition 93 -- (3) Structuring Payment 94 -- (4) The Management Service Organization (MSO) Model 95 -- (5) The Physician Hospital Organization (PHO) 95 -- (6) Foundation Models 97 -- (7) Capitation Issues 97 -- (8) Medical Practice Mergers 98 -- (9) Rural Hospital Networks 99 -- (10) Freestanding Outpatient Facilities and Services 100 -- (11) Joint Ventures 101 -- (12) Unwinding Deals 102 -- Chapter 5 Utilization Review 105 -- 5.02 Joint Commission for the Accreditation of Healthcare Organizations (JCAHO) 110 -- Part 2 Regulatory Matters -- Chapter 6 Tax Issues 115 -- 6.01 The Section 501(c) Exempt Institution: Qualifying for and Maintaining the Exemption 115 -- (1) The 501(c) Exemption: Advantages and Disadvantages 118 -- (2) Charitable Purpose Defined 121 -- (b) Charitable Hospitals 122 -- (c) Charitable Nursing Homes 125 -- (d) Charitable Professional Standards Review Organizations 125 -- (e) Charitable Share Service Organizations 125 -- (f) Individual Practice Associations 125 -- (g) Faculty Group Practice Plans 126 -- (h) Integrated Delivery Systems 126 -- (i) Physician Hospital Organizations 126 -- (j) Other Charitable Organizations 127 -- (k) Intermediate Sanctions 127 -- 6.02 Unrelated Business Income Tax (UBIT) 129 -- 6.03 Application of Federal Tax Laws to Corporate Restructuring and Joint Venturing 130 -- 6.04 State and Local Taxes 133 -- 6.05 Tax-Exempt Financing 134 -- 6.06 Taxation of Health Benefits 135 -- 6.07 Audit Issues 135 -- 6.08 For-Profit Conversion Issues 137 -- Chapter 7 Antitrust Issues 143 -- 7.01 General Application of Antitrust Principles to Health Care 143 -- 7.02 Antitrust Issues Raised by Provider Activities 149 -- 7.03 Merger and Joint Venture Developments 153 -- 7.04 Antitrust Implications of Integrated Delivery Systems 160 -- 7.05 Government Enforcement Activities 164 -- Chapter 8 Provider Reimbursement Issues 169 -- 8.02 Medicare 175 -- (2) Part A: Inpatient Services Related to Acute Hospital Inpatient Care 179 -- (a) Diagnosis-Related Groups 179 -- (b) Special Payment Rules for Certain Costs 180 -- (3) Part B: Outpatient and Physician Services 182 -- (4) Medicare+Choice Program 183 -- (5) Home Health Care 186 -- 8.03 Medicaid 187 -- (1) General Framework 187 -- (2) Reimbursement Principles 190 -- (3) Recent Reforms 191 -- 8.04 Reimbursement Review Activities: Peer Review Organizations 200 -- 8.05 Fraud and Abuse Statutes: Proscribed Conduct 200 -- (1) False Statements or Claims 203 -- (2) Illegal Remuneration (Stark I and II) 214 -- (3) Other Illegal Acts 218 -- 8.06 Civil Monetary Penalties Law 221 -- (1) Proscribed Conduct 221 -- (2) Civil Monetary Act Procedures 222 -- 8.07 Audits 222 -- 8.08 Private Insurance 223 -- Chapter 9 Bankruptcy and Insolvency 227 -- 9.02 Hospitals 230 -- 9.03 Managed Care Organizations 230 -- Chapter 10 Health Care Planning 233 -- 10.01 The National Health Planning Act 234 -- 10.02 Planning Activities 235 -- Chapter 11 Regulation of Private Health Care Financing 239 -- 11.01 Regulation of Private Insurance 240 -- 11.02 The Employee Retirement Income Security Act of 1974 (ERISA) 243 -- 11.03 Regulation of Managed Care 249 -- Part 3 Licensure, Liability, and Labor Issues -- Chapter 12 Licensure of Health Care Professionals 253 -- 12.01 Physicians 255 -- 12.02 Nurses 256 -- 12.03 Physician Assistants 258 -- Chapter 13 Professional Relationships in the Health Care Enterprise 261 -- 13.01 Medical Staff Issues 262 -- 13.02 Quality 264 -- 13.03 Professional Peer Review 267 -- 13.04 Physician Deselection 270 -- Chapter 14 Labor Issues 273 -- 14.02 Physician Unionization 276 -- Chapter 15 Liability of Health Care Professionals 279 -- 15.01 Liability for Patient Injury 279 -- 15.02 Obligation to Obtain a Patient's Informed Consent 294 -- 15.03 Obligation to Report Abuse 299 -- Chapter 16 Liability of Health Care Institutions 301 -- Chapter 17 Liability of Managed Care Organizations 311 -- 17.02 Tort Liability 316 -- 17.03 Liability for Provider Exclusion 321 -- Chapter 18 Obligations to Provide Medical Care and Access 323 -- 18.02 Emergency Medical Treatment and Active Labor Act (EMTALA) 328 -- 18.03 Obligations to Provide Care Under State Law 332 -- 18.04 Obligations under the Hill-Burton Act 333 -- 18.05 Nondiscrimination Obligations Under Title VI of the Civil Rights Act of 1964 334 -- 18.06 Discrimination Against Persons Based on Medical Condition 335 -- 18.07 Financial Criteria 335 -- (1) Denial of Nonemergency Treatment for Financial Reasons 335 -- (2) Termination of Nonemergency Treatment for Financial Reasons 336 -- 18.08 Grievance and Appeal Procedures 336 -- 18.09 Health Insurance Portability and Accountability Act of 1996 (HIPAA or Kennedy-Kassebaum) 337 -- 18.10 Balanced Budget Act of 1997 (BBA) 339 -- Chapter 19 AIDS Issues 343 -- 19.02 Legal Issues Relating to Treatment of Patients with AIDS or HIV Infection 352 -- (1) Duty to Treat 352 -- (2) HIV Testing of Patients 353 -- (3) Duty to Provide a Safe Workplace 355 -- (4) Privacy 355 -- 19.03 Issues Relating to Health Care Professionals with AIDS or HIV Infection 358 -- (1) Risk of Transmission 358 -- (2) Employment Laws: Legal Protections for Employees with HIV 359 -- (a) Prohibition Based on Handicap 359 -- (b) General Duty of Employer to Deal Fairly 359 -- (c) Other Sources of Employment Rights 360 -- Chapter 20 Environmental Concerns Affecting Health Care Facilities 363 -- 20.02 Waste 366 -- (2) Regulated Medical Waste 366 -- (b) Regulating Agencies 367 -- (c) Medical Waste Tracking Act 368 -- (d) Segregation, Packaging, and Labeling of Medical Waste 368 -- (e) Disposal Techniques 368 -- (i) Incineration 369 -- (ii) Autoclaving 370 -- (iii) Landfilling 370 -- (iv) Microwaving, Irradiation, and Chemical Disinfection 370 -- 20.03 Emergency Planning and Community Right-to-Know Act (EPCRA) 370 -- Chapter 21 Medical Records and Privacy Issues 373 -- 21.02 Privacy Issues 378 -- 21.03 Information Garnered from Genetic Testing 385 -- 21.04 Telemedicine 396 -- Chapter 22 Health Care Reform 401 -- Appendix A Health Law Periodicals, Digests, and Newsletters 421 -- Appendix B Reference Sources and Government Serials 455 -- Appendix C Computer Databases and Internet Sites 457 -- Appendix D State-by-State Synopsis of Selected Statutes of Limitation Laws 471 -- Appendix E Table of Acronyms and Abbreviations 473 -- Appendix G Relevant Federal Agencies 513 -- Appendix H Selected Nongovernmental Agencies 523 -- Appendix I State Laws Governing Medical Records 533 -- Appendix J Health Care Financing Administration Regional Offices 547.

ISBN

0787955043 (hc : alk. paper)

LCCN

^^^00054593^

OCLC

45621036
SCSB-9985122

Owning Institutions

Harvard Library