Health care managers need to be able to evaluate standards of care and potential liability for health care professionals and organizations. As a health care manager, you have been asked to prepare a p

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********* ********** or sexual orientation ************ ********* *** *********** for advocating for the health *** ***** of patients within *** ********** system ** ******** ** ** *** ************** ** the ******** ** ** ********** ********* *** ********** ** the ********* ******* ********** *** ******* ** ensure **** **** ** tailored ** *** ********* ******** ************ ********* 2005) ******* ** is the ************** of the ******** ** *********** *********** with other members ** *** ********** team ** ****** **** patients ******* coordinated ************* careSlide ** ***** *** ******* ********* *** ********** Enactment ** ******* ****** and **************** Ø ******* ********* and Regulatory ** ******* ***** *** Responsibilities· Health ********* *********** and ************** *** ** *********** is * federal law **** proposes *** creation ** * national ******** ** ******* ********* ******* ****** information **** being disclosed ******* ******* ******* ** knowledge ******* ******* ***** Relates to patients' ***** ** ******* concerning ***** medical ************ Health information ********** for ******** *** clinical health ******** ** relevant ** protecting ******* ****** ** ******* ******* *** *********** ************* *** Health ********* *********** *** ************** *** ** 1996 ******* ** * federal *** that ******** *** ************* of ******** ********* to prevent the ********** ** sensitive ******* ****** information ** ***** ******* ******* ******* consent *** ****** ********* *********** *** Accountability Act ** **** ******* ******* ** patient ****** regarding medical ******* patient *********** *** *********** ********** ******* ***** Patients **** the ***** ** have ***** ******* ******* kept confidential *** **** viewed ** ***** with a **** ** **** ** ******** by *** ******* *********** *** **** ** ******** **** patient ********** ** applicable **** and regulations *** patient has *** right ** ******* ********** ** *** obtain information ** 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and ********** Enactment on Patient Rights *** ****************** *** state **** ******* California Consumer ******* ********* is a *** **** ****** *** California ******** to ****** to *** *** *** information * company *** ***** ** ****** This law ******* ** ********* ***** ** ******* ******* **** ** third ******* such ** healthcare providers *** ********** ********** Care ******** provides ******* **** coverage ** low-income consumer· The ******* have *** ************** ** ************ a ********* **** they have ****** ** ********* instruction **** ***** and ****** personnelNotes *** ********** consumer ******* *** ****** is the *** **** ******* *** California consumer ** ****** ****** ** *** *********** ****** ** * business This ******* law ******** directly ** *** ***** to privacy ** ********** identifiable *********** ********* ** ******* ******* *** Affordable **** *** ***** ******** *** ********* of ******* ******** *** ******* **** federal *** **** ******** ****** to expand 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********* need ***** ***** (Byrd Powell & Smith ***** A ****** form ** fraud entails practitioners *** bill *** ******* **** **** ***** ******** **** ***** ***** from *************** ************* to ********* procedures By ********** ***** claims for services that were ***** ******** ***** ************* ******* ****** compensation **** ********* ********* ** ********** programs ultimately ********** *** cost of ********** *** ******** ***** ****** & ***** ***** ******* prevalent deceptive practice ******** ********** ********* ********** ******** ****** *** *** same service **** *** be ** ******** ** ******** ***** ************* or ******** intentionally Similarly ********* *** *********** ******** as if they **** covered ** ** ******* ** ******* ********* ********* **** ****** for ************ ********** ** ********** ** maximize ******* ************ ******* ******* *** ********* false *********** on diagnoses or procedures *** ******** ***** ****** & ***** ***** ********** professionals *** ********** *** ******** ** * ********* condition or ****** **** **** ********* ********** **** ********* **** **** of ***** *** ***** ********* ********* to ********** *** ******** **** were neither ********* *** *************** 11: ***** *** ******** Penalties ****** ** Healthcare FraudØ *** ******** ********* *** ********** fraud ********* False ****** may ******* five ***** ** ****** *** ******** ***** ** $250000· People found to ******* ************* ******** **** ******** ***** of ****** *** five **** ****** ** *************** * **** of ****** for **** violation ** ************* statutes and a **** of ****** for each ******* ****** ** *** ********* general ****** * **** of ****** for each **** ** ******** ** ******** party ***** ** ******** an excluded ***** ******* ** **** ************* ************ for perpetrating healthcare ***** *** ****** *** ************ to *** offense's ******* ** * ****** ** ************ is ***** ****** ** ********** ***** ****** they could face ****** ************ ********* imprisonment for ** to **** ***** *** ******** ********* ** up ** $250000 This ********* ** * formidable ********* ******* ***** *** ***** ******* ** defraud *** system *** ******** gain In ******** those *** ******* ************* **** ***** *** in ***** to ******* ******** ********* ********** in ********** ************ face ****** ********* ***** ****** ***** ***** ***** ********** *** ******* to ********* of up to ****** and * maximum ****** sentence of **** ***** The ******** ** ********* ***** ********** highlights *** ************ ** maintaining *** ********* ** ********** ************ *** ********* ** ***** ***** at ******** ****** *** ***** ********* **** specifies penalties *** each violation ** ************* **** and **** ********** ***** ***** violation ** ************* ******** ******* * $50000 **** *********** the ******* **** ******** to ********** ********** ********* for ******** **** **** not ** tolerated ***** Powell & ***** ***** ** ******** **** ***** ***** ********* carries ** $11000 ******** **** ********* ** * ******** ******* *** **** ********** *********** ************ ******** to ******* *** ********** ****** *** ************ of healthcare fraud ****** beyond legal ********* *********** regulatory ****** play * ******* **** in ********** the integrity ** *** ********** ****** *** ********* ********* ****** (OIG) ** *********** *** ******** ********** *** ************ fraud ** ** excluded ***** ********* ** **** Medicare *** ***** or services the *** *** *** authority to impose fines of ****** per **** ** ******* ****** (Byrd ****** ***** ***** ***** **** functions ** * ********* ******* ******** ** engage ** ********** ********* **** ** ******** parties *** ************* *** Conclusion ** The ******** of care ********** **** ** **** ******* privacy *** ******** ************* and ******* supportØ The ********** ****** *** **************** include· ***** ** ****** ******** ***** ********* ***** ** ******** for patient rights· ***** the provider *** **************** ********** *** patient ********** *** ************* **** ******* providerØ ******* *** ****** **** relative ** patient ****** *** **************** include· ********** **** *** ***** California ******** ******* Act ****** ***** ****** *** ******** ********** fraud ******* ******** ***** ****** ********* ******* recordsØ ***** ******* five-year imprisonment *** * fine ** ************************* S ******** T *********** * ** ***** M ******** * ***** P ***** Turillazzi * ****** *** ***** on patient ****** *** ************ ********* *** *** ******* ****** ******* ******* ************** ************* 20(8) *********** * ****** * ***** ***** D ****** Health **** ****** ** ************ ** * major cost ***** ******* of ********** Ethics and Public ****** ************* * (2005) ****** vs ***************** ************ ********* *** ******** refusalsThe Guttmacher Report ** ****** Policy8(3) ********* * * ****** *** ***** ******* **** and *** ** ***** illustrative **************** **** * Rev47 *****