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Understanding Health Care Law

2/8/2008 1:29:24 PM EST

Could you repeat that, please?

Posted by AME3bg

Just starting out in the Health Care Law field? A basic knowledge of the terms of art is key to impressing your client or managing partner with your ability to handle Health Care Law matters competently. Read on for a quick primer!

Self-referral – doctors or practices inducing the referral, recommendation, or arrangement of medical services/business to themselves;
False claim – submitting a request for payment based upon a false claim/services not rendered (regulated by False Claims Act; fraud and abuse statutes; and anti-kickback laws);
Fraud and abuse – ties in with false claims; highly regulated; making a false claim or statement to a health care program (usually Medicare or state program);
HIPAA (Health Insurance Portability and Accountability Act) – regulations that govern the privacy of patients records, whether in electronic format or print;
Stark laws – regulations that health care providers and hospitals must comply with regarding physician contracting, recruitment, and other financial arrangements;
Tax-exempt status – if a hospital is not-for-profit, it will be exempt from property, sales, and income taxes, so once this status is obtained, it’s important to maintain.
Patient confidentiality – maintaining medical information as confidential; doctor-patient privilege;
Consent to medical treatment – whether or not a patient has the capacity to consent to treatment or if he/she is somehow incapable of making an informed decision;
Health care proxy – also called a durable power of attorney for health care; appointing someone to have authority to make medical decisions on patient’s behalf if he/she is unable to.

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