Legal Standard Project

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School

Clarkson College *

*We aren’t endorsed by this school

Course

HM495

Subject

Medicine

Date

Apr 3, 2024

Type

docx

Pages

Uploaded by olubunmiayanfe

Legal Standards Project 1. You are the new practice manager for Meadow Pediatric Care, a pediatric primary care group owned by Dr. Charles Greene. Meadow Pediatric Care serves a large Medicaid population. As you review policies, you find that all referrals for speech-language pathology services are made to Children’s Speech and Language Services of Valley View (CSLSVV), which is one of three area businesses that supply those services to children. As it happens, your sone has had services from the CSLSVV, and you know that the business is owned by Dr. Greene’s sister, Dr. Sherry Watt. 1. What could this discovery mean for Dr. Greene? Apply the appropriate federal statute. To what corrective action might he be subject? 2. Upon further investigation, you find that a monthly deposit is being made from CSLSVV into the pediatric groups account. What could be inferred from this transaction and what federal statute would apply? To what penalties might Dr Greene be subject? 3. Could the term “safe harbor” have any relevance in this scenario? Justify your answer. 1. Discovery of referrals to family members business: The Federal Statutes that may be applicable to this scenario is the Anti-Kickback Statutes with the following implications for Dr. Greene:  Medicaid is a federal healthcare program. Anti-Kickback statutes prohibit the exchange of anything of value to reward the referral of federal healthcare program business.

 Dr. Greene's referrals to his sister's business may be considered a violation of the AKS.  Corrective actions may include fines, exclusion from federal healthcare programs, and potential imprisonment. 2. Monthly Deposit from CSLSVV to Pediatric Group's Account: The Federal Statute that prohibits physician self-referral for certain designated health services is the Stark Law. The following are the likely penalties:  If CSLSVV, owned by Dr. Greene's sister, is making deposits to the pediatric group's account, it could suggest financial arrangements between the entities.  If these transactions involve referrals for designated health services, it may violate Stark Law.  Penalties for Stark Law violations may include fines, repayment of amounts collected, and potential exclusion from federal healthcare program. 3. Relevance of “Safe Harbor”: safe harbor regulation protects certain payment and business practices that could potentially implicate AKS from criminal civil prosecution if the necessary requirements are met (Brodnik et.al, 2017). The following are the relevance of safe harbor in this scenario:  If Dr. Greene's referrals to his sister's business meet the conditions of a safe harbor, it may provide protection against AKS violations.  However, safe harbors are specific and must be strictly followed to provide protection.

 If the financial transactions between CSLSVV and the pediatric group do not fit within a safe harbor, the AKS violations may still be applicable. Overall, the discovery of referrals to Dr. Greene's sister's business and financial transactions between the businesses raises potential legal and ethical concerns. Dr. Greene could be subject to penalties under the Anti-Kickback Statute and the Stark Law. The application of safe harbors depends on whether the arrangements meet specific conditions outlined in the law. 2 . As the HIM Director, you have been served with a subpoena to produce records for an upcoming court case. Your release of information clerk is new, and when you direct her to the procedure to follow for preparing records in response to a subpoena, you find there is none. What steps should you include in the procedure? Elements of a valid subpoena must be verified which includes:  The name of the court from which the subpoena was issued  The caption of the action (name of the plaintiff and the defendant)  Assigned case docket number (to validate the case)  Date, time, and place of requested appearance  The information required, such as testimony or the specific documents sought in a subpoena duces tecum  The form in which that information is to be is to be produced  The name of the issuing attorney  The name of the recipient being directed to disclose the records

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