Compliance
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Case Managers Should Beware of Medicare Fraud, Waste, and Abuse Issues
All hospital employees, including case managers, should receive frequent compliance training that includes information about how to prevent compliance problems.
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American Hospital Association Sues CMS Over Final Rule Changes to OPPS Payments
The American Hospital Association has sued the U.S. Department of Health and Human Services to prevent changes to how Medicare reimburses care in hospital outpatient departments.
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Nonoperating Physician Found Exempt From Liability
This matter provides several insights as to the duty of care in medical malpractice suits, the legal relationships among physicians working within the same practice or at the same facility, the respective burdens of proof, and the roles of expert opinion testimony.
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Improper Medication Leads to Patient’s Death, $10 Million Verdict
In this case, both parties relied heavily on expert opinions to attempt to prove or disprove the causal link between the course of treatment chosen and the onset of the ischemic colitis that led to the patient’s death.
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Emergency Preparedness Pays Off When Water Supply Lost
A Utah health system confirmed the value of emergency preparedness when it was faced with a severe water shortage after a wildfire.
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Pediatric Safety Still Threatened by Electronic Health Records
Pediatric patients are at risk from electronic health records that do not adequately factor in their needs. Medication dosing is the biggest threat.
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FTC Investigations Could Bring Unwanted Scrutiny to Hospitals
The Federal Trade Commission is investigating whether hospitals and health systems violated antitrust laws through contracts with payers. Assess your risk before the government investigates.
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Establish Expectations, Communication With Outside Counsel
A hospital is best served when in-house counsel work closely with outside counsel. In-house counsel can provide background information and assistance, as they are the most knowledgeable about the hospital’s structure, policies and procedures, culture, and personalities.
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Outside Counsel Can Be the Right Choice, but Know When
Outside counsel can be an important resource for hospitals and health systems, but knowing when it is right to bring in someone can be difficult.
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OHRP Issues Guidance on Public Health Surveillance vs. Research
The Office for Human Research Protections recently published new draft guidance to clarify the difference between human research that might require IRB review and public health surveillance that is not defined as research.