The Legal and Regulatory Environment of Health Care

The Legal and Regulatory Environment of Health Care

Textbook: Fremgen, B. F. (2014). Medical law and ethics (5th ed.). Upper Saddle River, NJ: Pearson.

Instructions: Please ensure to substantiate your response with scholarly sources and also a personal account of your own experience in the work place. Cite and reference work! Must be 150 to 175 word count.

1. Please highlight two things you found most interesting about Chapter 1. See attached

1a. Read the Jeanette M case; based on the case address your opinion and thoughts to the comments below.

What reactions do you have to the ideas they presented? Include examples from the course readings or your own experience to support your perspective, and raise questions to continue the dialogue

Monica: In the case of Jeanette M. I don’t believe there is an ethical problem. If anything there may be a legal problem for the receptionist because she should have gotten more information regarding Jeanette’s condition. An elderly woman with shortness of breath should have been recommended to the ER. However, Jeanette is also partially at fault because she took no action to save herself sooner. She should have went to the ER on her own as soon as she became exhausted. I would say that the doctor had no part in her death and both the receptionist and Jeanette were at fault (if I had to place blame). If the receptionist had taken the extra time to learn more about Jeanette, she may have referred her to the ER saving Jeanette’s life, maybe. Being that she was elderly, suffering from pneumonia and congestive heart failure, there may have been nothing they could have done.

BeaJae: I agree, on an ethical level had the receptionist given the doctor the message when it was first received Jeanette M could have had a response well before 5:00 P.M. It may or may not have saved her but at least the call would have been answered in a timely manner. I don’t believe that anyone is at fault for the death of Jeanette M and as a receptionist, the order of which the conversation had taken place was adequate because she is only a receptionist, the doctor would have to make the call on what Jeanette is to do as far as getting treatment. In a busy workplace anywhere a lot of things tend to go unanswered due to being understaffed, overworked, or misjudging a situation but in many of them someone is held to blame for the mishap. In this case i believe that there is no one to blame in the death of Jeanette only a delay in reporting the call.

2. Please highlight one thing you found most interesting about Chapter 2. See Chapter 2 attached

2a. Read the Case of Jacob and the diseased and share your thoughts

3. Please highlight one thing you found most interesting about Chapter 8. See Chapter 8 attached.

3a. Read the case of Janet K. and Epilepsy and share your thoughts

4. Read and share your thoughts about the Legislative Process page on the United States House of Representatives website. http://www.house.gov/content/learn/legislative_process/

5. Read and share your thoughts on the article “Why Is Health Care Regulation so Complex? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730786/

Based on the article above, address your opinion and thoughts to the comment below:

What reactions do you have to the ideas they presented? Include examples from the course readings or your own experience to support your perspective, and raise questions to continue the dialogue

5a. Kwan: This article provided a great summary of health care regulation in the U.S. and how it is managed by different levels of government: local, state, and federal. My personal experience working in medical billing and medical front office had been quite challenging at first as I had to learn HIPAA, ICD-9 (at the time), and Medicare/Medicaid compliance. Kind of a crash course if no one has had any official training or education on these subjects. However, I am glad to have experienced it first hand and now I am enjoying the work as a student. Students that learn about health care regulation and compliance at UOP are definitely going to be ahead starting a career in this industry if they aren’t working in it now – so lucky! This article provides examples from a physician and a pharmaceutical company’s perspective on how they require the necessary and legal regulations in order to provide treatment (physician) and sell the drug (pharmaceutical company). As for becoming a physician, it really makes people appreciate the hard work (time, money, and education) they put in in order to practice. Not only do they have to:

– attend a medical school that has received accreditation by a private body

– take a national examination administered by another nongovernmental organization

– obtain licensure from a state medical board

– complete a hospital residency that is funded and governed by the federal Medicare program

– achieve certification from a private specialty board

– AND obtain clinical privileges at a hospital that may operate as either a private or public entity 

..but they have to complete regulatory and compliance tasks throughout their career in order to continue to practice (Field, 2008). This helps us as consumers know that we are getting treatment from well-educated medical professionals that meet the necessary standards of law. 

Field, R. I. (2008). Why Is Health Care Regulation So Complex? Pharmacy and Therapeutics33(10), 607-608.

6. Read and share your thoughts on the Laws & Regulations page on the U.S. Department of Health &

Human Services website. http://www.hhs.gov/regulations/

7. Health Care Governance in the US:

Who should be responsible for governing health care delivery in the United States? What should the role of the government be, if any?

8. Government and Health Care

What function does each federal branch of government serve in relation to health care delivery?

Do you think they do a good job?

9. Read and share your thoughts on the Regulations overburden health care article. http://www.edermatologynews.com/single-view/regulations-overburden-health-care/f7bb02a29855cd0ec55a043e1ce29e02.html

10. Complete the Health Care Laws Matrix below. Cite/ reference with proper APA style.

· Explain how health care laws are created. 

· Evaluate the impact of local, state, and federal laws on the health care industry.

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