Health Care Governing Board Case Order Instructions: health care case
part 1 #1-4
- Sunshine Hospital is in need of major renovation of its electrical system. One of Sunshine’s governing board members, Willy Watt, is an electrical contractor who is a partial owner of an electrical restoration company. He would like to bid on the project. May he? If he does, what must he do? What must the governing board do? Is there a problem with Mr. Watt’s fiduciary duty? Is there a problem with the governing board’s fiduciary duty? What would you recommend?
- Dr. Wilson is a gastroenterologist. As part of his informed consent, he includes an exculpatory contract that excuses him from liability in the event he commits an act of negligence. He will not operate on a patient unless they sign the contract. Dr. Wilson is the only gastroenterologist in a 50-mile radius. Are there any problems with Dr. Wilson’s contract? What do you expect a court to conclude if a patient does sue him for negligence after the patient has knowingly signed his contract?3. Which high-risk area associated with fraudulent billing practices do you think is the most problematic? Why?
- Of the six steps for an effective compliance program, outlined in the following website, which step(s) do you think is/are the most important? Why?
Health Care Governing Board Case Sample Answer
Question 1: In my opinion, Mr. Willy Watt should not bid in order to avoid conflicts of an organization. The main responsibilities of the board of members are to ensure financial accountability of the healthcare organization. The Board members are the trustee’s of organization assets. If he must bid, the governing board must exempt him from fiduciary duty. There is no problem with governing boards fiduciary as long as they remain trustworthy, loyal and accountable. However, there would be an issue with Mr. Watt’s fiduciary duty because there is conflict on Mr. Watt’s loyalty and interest (Gannons Solicitor, 2013).
Question 2: Dr. Wilson the gastroenterologist actions are permitted expect in a situation where the healthcare providers acts are proven as gross negligence. There is problem’s with the contract unless he coerces a patient to sign his contract without the knowledge of the liability exemption clause. If a patient sues him for negligence, he cannot be accused because the patient signed the contract knowingly (AHIMA, 2013).
Question 3: The areas associated with high incidences with fraudulent billing practices that are problematic are up-coding, patient identification error, cloning, phantom billing, repeated billing and service fragmentation and unbundling (AHIMA, 2013).
Question 4: There are six tips that facilitate an effective compliance program. These include establishing a culture of compliance, outlining procedures, policies, training, and effective communication, establishing ca corrective system and performing audits. These tips are all important, but the most important one is training. This is because continuous training will help the staff understand the importance of providing a commitment plan with technical and monetary support. Through training, the staff will understand the policies and procedures specific to their job function. Training process provides an opportunity for interaction between the various departments (National Law Review, 2016).
Health Care Governing Board Case References
AHIMA. (2013). Integrity of the Healthcare Record : Best Practices for EHR documentation (2013 update). Retrieved from http://library.ahima.org/doc?oid=300257#.WDi_EFzuTIU
Gannons Solicitors. (2013). Director’s responsibilities and Fiduciary duties. Retrieved from http://www.gannons.co.uk/company/directors/directors-responsibilities-fiduciary-duties/
National Law Review. (2016). OIG Posts Tips for implementing an Effective compliance program. Retrieved from http://www.natlawreview.com/article/oig-posts-tips-implementing-effective-compliance-program
