Solution Manual for Health Care Management and the Law Principles and Applications, 1st Edition

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  • ISBN-10 ‏ : ‎ 1428320040
  • ISBN-13 ‏ : ‎ 978-1428320048
  • Author: Donna Hammaker

Health Care Management and the Law: Principles and Applications engages students who will be leading and shaping twenty-first century health care organizations. It raises questions about health law issues such as emergence of the U.S. as a player in the global health care industry, innovative new approaches to the payer/provider model, and the future of tailored therapeutics. The text provides a comprehensive overview of health law, which is relevant to both undergraduate students seeking the basic management skills required to work in health care organizations, and graduate students currently working in health care organizations. The text is divided into thirteen broad parts ranging from an overview of specific health laws and affordable health care to producers of medical products and the future of health care in the U.S. Health Care Management and the Law concludes with a summary of improved medical technologies and the future of personalized health care. The technology-enhanced learning tools that accompany the text are available in multiple formats to fit individual readers’ learning preferences, including an online learning management system with a test generator, study notes, Web links, threaded discussion forums, and additional assignments; an instructor’s resource CD with PowerPoint presentations, Exam View test bank, instructor’s manual, and syllabus templates; and a student study guide.

Table Of Contents:

PART I INTRODUCTION

1(40)

Processes for Thinking About the U.S. Health Care System

2(14)

In Brief

2(1)

Fact or Fiction

3(1)

Principles and Applications

3(1)

“New” Approach to Health Care

3(4)

Data Driven

5(1)

Hypothesis Driven

5(2)

Neurology of Internal Patterns

7(1)

Power of Internal Models

7(1)

Filtered Thinking

8(1)

Test Mental Models

8(1)

Medical Innovation

8(1)

Preventable Medical Conditions v. Treatable Conditions

8(1)

World of Constant Change and Evolution

9(1)

Individual Micro-Trends

9(1)

Power of Thinking

10(1)

“Adaptive Disconnects”

10(1)

Support of “Old” Mental Models

10(1)

Misaligned Incentives

11(1)

Zooming-In and Zooming-Out

11(1)

Process of Making Sense of Things

11(1)

Understanding the Forces

11(1)

“New” Approach to Decision-Making

12(1)

Practical Implications of the “New” Neuroscience

12(1)

Law Fact

12(1)

Chapter Summary

12(1)

Law Notes

13(1)

Chapter Bibliography

13(3)

Introduction to Health Law

16(25)

In Brief

16(1)

Fact or Fiction

17(1)

Principles and Applications

17(2)

The Declaration of Independence

19(1)

U.S. Constitution and Bill of Rights

19(1)

Judicial Branch

19(2)

Organization of the Judicial Branch

19(2)

“The People” and the Judicial Branch

21(1)

Legislative Branch

21(3)

U.S. Congress

22(1)

Government Accountability Office

23(1)

Congressional Budget Office

23(1)

Executive Branch

24(13)

Expansive Growth and Resultant Long-Term Fiscal Gap

24(1)

Decline of Separate but Equal Governance

24(1)

Federal Departments and Agencies Affecting Health Care

24(13)

Use of Governmental Powers

37(1)

Law Fact

37(1)

Chapter Summary

37(1)

Law Notes

38(1)

Chapter Bibliography

39(2)

PART II OVERVIEW OF SPECIFIC HEALTH LAWS

41(46)

Health Care Compliance Programs

42(28)

In Brief

42(1)

Fact or Fiction

43(1)

Principles and Applications

44(1)

Definition of Health Care Fraud and Abuse

44(1)

Scope of Health Care Fraud

45(1)

Financial Incentives

45(13)

Anti-Kickback Prohibitions

46(8)

The Health Insurance Portability and Accountability Act

54(1)

Self-Referral Limitations (Stark Amendments)

54(1)

False Claims Act

55(1)

General Fraud Laws

56(2)

Government Enforcement of Health Care Fraud Laws

58(3)

Triple Plays

59(1)

Qui Tam False Claims Actions

59(1)

Deferred Prosecution Agreements

59(2)

Compliance Programs

61(2)

Best Practices

61(1)

Provider Disclosures

61(1)

Governance Responsibilities

62(1)

Confusion

63(1)

Health Care Fraud on Trial

63(1)

Cat-and-Mouse Compliance Games

63(1)

Icarus in the Health Care Industry

64(1)

Law Fact

64(1)

Chapter Summary

65(1)

Law Notes

66(1)

Chapter Bibliography

67(3)

Antitrust And Regulation of Health Care Providers

70(17)

In Brief

70(1)

Fact or Fiction

71(1)

Principles and Applications

71(1)

Defensible Theories of Wrongful Conduct

72(1)

Analysis of Competition&

73(1)

Defining Market Share

73(1)

Analyzing Wrongful Conduct

73(1)

Medical Mergers and Acquisitions

73(3)

Pre-Merger Economies

75(1)

Post-Merger Hospital Pricing

75(1)

Specialty Hospitals

76(1)

Nursing Wages Antitrust Litigation

76(1)

Physician Privileges and Credentialing

77(1)

Exclusive Dealing

78(2)

Using Antitrust Laws to Thwart Competition

80(1)

Life-Cycle Management of Drugs

81(1)

Antitrust Compliance

81(1)

Differences in Antitrust Philosophy

82(1)

Law Fact

83(1)

Chapter Summary

83(1)

Law Notes

83(1)

Chapter Bibliography

84(3)

PART III ACCESS TO HEALTH CARE

87(54)

Access to and Reimbursement For Medically Necessary Health Care

88(26)

In Brief

88(1)

Fact or Fiction

89(1)

Principles and Applications

89(1)

Access Challenges

89(1)

Coverage for the Uninsured or Underinsured

89(2)

Economics of the Uninsured and Underinsured

91(1)

Spillover Effect of the Non-Privately Insured

91(1)

Economic Cycle of Health Insurance

91(1)

Reframing Choices About Health Insurance

92(1)

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