Question

1. An employee is found to be making errors in documenting a patient’s chart and is given a verbal warning for this error. The employee is placed on a corrective action plan and is to receive training on the proper method of documenting a patient’s chart. The employee does not comply with the corrective action determined, and the employer fires the employee subsequently. Does the employee have the right to fight the termination of employment based on due process? Does the employer have to offer even more training for the employee?
2. Your organization has an employees-only blog. You’ve been tasked with writing a blog post to educate your co-workers about Stark Law and how to be in compliance. Make sure to include the law’s purpose, what it forbids and does not forbid, mandatory disclosures, and other facts you think are important. Use simple language, not legal jargon. The tone of the post should be professional, yet friendly.
3. A patient is admitted to the hospital with gallstones and needs to have his gallbladder removed. This is considered an emergency surgery because of the position of the stones and the level of patient pain. The patient also suffers from type 2 diabetes that is not well controlled. The patient undergoes surgery and the gallbladder is found to be gangrenous; the gallbladder is removed but the patient suffers from jaundice following surgery. After follow-up testing, it is determined that the bile duct from the gallbladder was damaged during the emergency surgery and the patient needs another surgical procedure to repair its damage. How would the components of negligence be met in this case? Are there any other mitigating factors involved?
4. Describe how you can protect yourself and your employees (or will protect, if not currently a medical supervisor) from negligence or errors in your work. In what ways are you most vulnerable? Identify key areas on which you will focus. Consider communication, documentation, training, and other issues.
5. Investigate HIPAA Violations & Enforcement. What government agencies enforce HIPAA privacy and security rules? How do they do so? Describe the range of civil penalties imposed and the types of violations that cause them. What causes criminal penalties and what government agency handles them?
6. Evaluate the Ohio Health Employee Code of Conduct and the M.D. Anderson Cancer Center Compliance Plan. Summarize what each says about how they will monitor compliance. Who is responsible for implementing and managing their compliance program? What policies do they have in place for employees to report compliance concerns? How does each handle corrective or disciplinary action? Finally, describe one or two items included in these documents that you found interesting, surprising, well-done, or lacking.

Answer 1

#. The employee does not have the right to fight the termination of employment based on due process because he or she haven't complied with corrective action even after the provision of training.

I don't think the employer have to offer even more training for the employee when the employee is not a showing an interest to modify his or her actions .

#. Stark Law :-

Def: Federal civil laws prohibit MD self-referral, spec. a referral by a MD of a Medicare or Medicaid pt to an entity providing designated health services (DHS) if the physician (or his/her immediate family member) has a financial relationship

Examples:

A. Physician has stake in a private imaging center, refers to another physician who then refers to that imaging center (downstream referral)

B. Services performed by a partner but not billed under the group number (exceptions for groups means all services have to be billed under a single group TIN)

Penalties for violations:

1. Denial of payment for DHS provided (refund)

2. Payment of civil penalties of up to $15,000/service that a person "knows or should know" was provided in violation of the law

3. Exclusion from Medicare program and/or state healthcare programs including Medicaid

4. Payment of civil penalties for attempting to circumvent the law of up to $100,000/ circumvention scheme

Stark Law Exceptions

Referals to:

1. MDs in same group

2. In-office ancillary services

3. MDs within prepaid health plans

4. Entities in which MD is invested (publicly traded entities, hospitals in Puerto Rico, rural providers and a hospital itself).