HEALTH LAW AND ETHICS

FIND THE REGULATIONS THAT APPLY FOR EACH AND CITE THEM

1. You are a physician in a four doctor group practice. You would like the group to purchase an X-Ray machine as an ancillary diagnostic service to their medical practice. The group agrees but insists that all fees for the technical component billed to Medicare for the X-Rays should be split up based solely upon who ordered the test. (The technical component is the charge for the X-Ray itself and is not for the professional part of the radiologist or other doctor who reads or interprets the X-Ray.) Also, there is not enough space at the office building where the group practices to house the MRI machine so they want to lease space in the building next door for the MRI. What is your response to these proposals.

(I suggest looking to the fraud and abuse regulations to find support for your answers i.e. Stark and the Anti-Kickback Act. First, determine whether the laws apply and then see if there is a Stark exception or Anti-Kickback safe harbor that addresses this ancillary service and if the proposals are compliant with those exceptions or safe harbors. If not, why not?)

1. You are the compliance officer of a Medicare certified hospice. In reviewing this month’s claims submitted for payment to Medicare you discover that of the 15 new hospice admissions, for the first 90 days of hospice coverage, the medical records contain 10 written certifications of terminal illness signed by the hospice medical director within 48 hours of the initiation of service; 2 were written and signed but only after 5 days from the initiation of service and 3 have no written certifications at all, however, your staff confirms that for those last three, each of the patient’s attending physician verbally certified the terminal illness. All of the written certifications state the time frame for life expectancy for the newly admitted patients, however, the staff forgot to verify the time frame of life expectancy in their verbal conversations with the 2 attending physicians who gave verbal certificates. You decide to call the two attending physicians. What time frame of life expectancy do you need to confirm? Also, of these 15 new claims, how many do you think could be denied for payment by Medicare and why?

(This problem requires a careful analysis of the Medicare reimbursement coverage issues).

1. You sister would like to start a new personal care attendant healthcare business. A personal care attendant (“PCA”) business is licensed by the State of Louisiana as part of the Home and Community Based Service Providers. Essentially, a PCA company provides direct service workers to go to people’s homes who have disabilities to help them with Activities of Daily Living, and some very basic medication management. Your sister has asked you to help her with some licensing questions, as follows:
2. Is it OK to base the company out of her home until she makes enough money to rent an office?
3. She can secure financing from her bank through a line of credit but only for $50,000, is that enough?
4. Your sister would like for her boyfriend to be a co-owner, he has a prior misdemeanor conviction for possession of marijuana. Would that prohibit him from being an owner?
5. Once the PCA company starts making money and she moves it into a new office, she would like to sell her home and establish residency in Bay St. Louis, Mississippi, just across the border. She doesn’t mind the commute and plans to continue to serve as the PCA company’s administrator. She has a college degree and use to work for five years for the Council for the Aged in Slidell providing service to the elderly. Is that OK?

(I suggest looking to licensing regulations to find support for your answers).

1. You are the hospital administrator of one of three large hospitals in Metropolis, Louisiana. You would like to institute a new policy to help the city’s ambulance company by replenishing the ambulances that transport patients to your hospital’s emergency room with drugs, linens and other supplies that the ambulance EMT crew may have used in stabilizing the patient prior to transfer. You need to establish a policy that is compliant with the Anti-Kickback Act to avoid having a problem with Medicare should the other hospitals complain that you are giving the ambulance company a kickback to steer patients to your emergency room. Draft a policy to replenish the ambulances that is compliant with the Anti-Kickback Act.

(This is obviously a Federal Healthcare Program Anti-Kickback problem. Is there an applicable safe harbor?)

1. You are psychologist. Your last patient just left your office. She had just been fired from her position as a school counsellor and she was extremely bitter. During the therapy session she said that she wanted to “get even” with the school administration and “make them pay” for firing her which she believes was completely unjustified. You were unable to get any more details regarding her feelings about being fired. Can you disclose what she said and if so, to whom?

(Consult the Privacy Rules under HIPAA, and determine what one must do under the law in a case like this).

 PLEASE FOLLOW THE INSTRUCTIONS BELOW

4 REFERENCES

ZERO PLAGIARISM

Assessment is as essential to family therapy as it is to individual therapy. Although families often present with one person identified as the “problem,” the assessment process will help you better understand family roles and determine whether the identified problem client is in fact the root of the family’s issues. As you examine the Hernandez Family: Sessions 1-6 videos in this week’s Learning Resources, consider how you might assess and treat the client family.

Learning Objectives

Students will:

• Assess client families presenting for psychotherapy

To prepare:

• Review this week’s Learning Resources and reflect on the insights they provide on family assessment.
• View the Hernandez Family: Sessions 1-6 videos, and consider how you might assess the family in the case study.

Note: For guidance on writing a comprehensive client assessment, refer to pages 137–142 of Wheeler (2014) in this week’s Learning Resources.

The Assignment

Address in a comprehensive client assessment of the Hernandez family the following:

• Demographic information
• Presenting problem
• History or present illness
• Past psychiatric history
• Medical history
• Substance use history
• Developmental history
• Family psychiatric history
• Psychosocial history
• History of abuse and/or trauma
• Review of systems
• Physical assessment
• Mental status exam
• Differential diagnosis
• Case formulation
• Treatment plan

1) Minimum 6 full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)

Parts 1,  2 are the same, HOWEVER, your answer and references must be 100% different. That is, you must answer from 2 different perspectives, always approaching the question objectively.

Parts 3, and 4 are the same, HOWEVER, your answer and references must be 100% different. That is, you must answer from 2 different perspectives, always approaching the question objectively.

             Part 1: Minimum 2 pages

             Part 2: minimum 2 pages

             Part 3: Minimum 1 page

             Part 4: Minimum 1 page

Submit 1 document per part

2)¨******APA norms

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.do

__________________________________________________________________________________

Parts 1, and 2 are the same, HOWEVER, your answer and references must be 100% different. That is, you must answer from 2 different perspectives, always approaching the question objectively.

Part 1: Pharmacology 1

L.L. is a 67-year-old male who has been diagnosed with BPH. He is having difficulty with urination. He is currently on Cozaar 100 mg for HTN and his BP is well controlled. He is taking no other medications. The doctor has recommended medication for his BPH, but he would like to try a herbal supplement before taking a prescription medication.

1. Would you recommend a herbal supplement in L.L’s case?

2. If so, what herbal supplement would he take?

3. What is the recommended dosage?

4. What are possible side effects of the herbal supplement?

5. What warnings should you give L.L. before he starts the herbal supplement.

Part 2: Pharmacology 2

L.L. is a 67-year-old male who has been diagnosed with BPH. He is having difficulty with urination. He is currently on Cozaar 100 mg for HTN and his BP is well controlled. He is taking no other medications. The doctor has recommended medication for his BPH, but he would like to try a herbal supplement before taking a prescription medication.

1. Would you recommend a herbal supplement in L.L’s case?

2. If so, what herbal supplement would he take?

3. What is the recommended dosage?

4. What are possible side effects of the herbal supplement?

5. What warnings should you give L.L. before he starts the herbal supplement.

Parts 3 and 4  are the same, HOWEVER, your answer and references must be 100% different. That is, you must answer from 2 different perspectives, always approaching the question objectively.

Part 3: Advanced Primary Care of Family Practicum 1

 Read the following article carefully: https://www.medicare. gov/yourmedicarecosts/get-helppayingcosts/medicaid

1. Reflect on Medicare or Medicaid 

2. Discuss which has a greater impact in the state where you plan to practice?

Part 4: Advanced Primary Care of Family Practicum 2

 Read the following article carefully: https://www.medicare. gov/yourmedicarecosts/get-helppayingcosts/medicaid

1. Reflect on Medicare or Medicaid 

2. Discuss which has a greater impact in the state where you plan to practice?

Read the following article carefully: https://www.medicare. gov/yourmedicarecosts/get-helppayingcosts/medicaid

Reflect on Medicare or Medicaid and discuss which has a greater impact in the state where you plan to practice?

FLORIDA

Select a nurse theorist and write a paper describing the background of the theorist, the theory, and its application to nursing practice. The paper should address the following:

1. Describe the background of the nurse theorist and the various social and professional issues that influenced the development of the theory.

2. Identify the major concepts and relational statement of the nursing theory. Concepts common to most nursing theories include: Person, health, nursing, and environment.

3. Describe the assumptions made by the nurse theorist. To what extent are these assumptions compatible with your personal philosophy of nursing?

4. Apply the theory to a clinical situation and describe how its use will improve nursing care or influence the way care is given.

The paper must be typed in APA format with a minimum of 1000 words (excluding first and references page) with a minimum of 4 evidence-based references using the required Arial 12 font. Follow the APA example paper under the folder APA tools. Make sure references are used according to APA guidelines and electronic references must be from reliable sources such as CDC.