Legal Aspects of Healthcare Administration Goodhealth
Question:-
You lead a multi-disciplinary team that deals with compliance issues for GoodHealth, Inc., a large healthcare provider that owns four hospitals. Your team did some investigating, including internal audits and confidential interviews, and they found the following:
Your team has concluded that it is in the best interest of GoodHealth, Inc. to self-report to the OIG. The team must prepare a paper for the CEO. The CEO will submit the paper to the Board of Directors. Be creative. How should this be approached?
What sort of penalties can be imposed by the OIG to address this? (physician peer review for medical errors is not taking place in a consistent or timely manner.)
Have the Directors breached any legal duty?
Should the organization self-report?
Answer:-
Corporate and social responsibilities refer to the ethical obligations or responsibilities that are present and the hospitals need to do some benefits for these issues or obligations like the delivery of the quality and superior health care to each and every one. The challenges faced by the health care sectors, the health care officials and business managers, as well as the medical professionals, is continuously exploring the paths for ensuring the welfare and the wellbeing of the patients that are the highest priority as well as to promote the health care impartiality by means of corporate and social responsibilities and actions.
GoodHealth are not taking any timely action on a consistent manner, therefore OIG can impose penalties that involve violations regarding 'Federal criminal', 'Civil or Administrative law' etc. OIG can impose civil monetary penalties by following the 'Civil and Administrative law'. A civil penalty is a kind of financial penalty that can be imposed by OIG for any kind of wrongdoing (N. Callender & A. Hastings, 2018). Penalties in form of $17 million can be imposed on the health care organization for the reason inappropriate reporting. The violation of Civil and Administrative law leads to penalties such as criminal offenses, monetary fines and more harsh punishments such as banning of the medical service license for the respective organization. Federal criminals or crimes are offenses that particularly violate federal laws (Oig.hhs.gov, 2016). The OIG prosecutes offenses committed and further impose penalties on them that are more severe in comparison to the penalties charged by state courts.
The directors were responsible for the breach of self-disclosure policy in health care under the HHS Act. Reporting of errors is very much crucial in healthcare settings is very much important from the perspective of the healthcare providers. The HHS Act of USA ensures that the healthcare organizations do comply with the basic protocols of self-disclosure or reporting policies to the OIG. The investigation suggested that the administration had failed to properly report the errors within their medical diagnosis systems (Oig.hhs.gov, 2016). They were not regularly monitoring the technical machines and tools that are used for obtaining significant medical data by diagnosing the patient. Section 1128J(d) of the HHS Act describes the nature of self-disclosure reporting by various hospitals and healthcare units. Providers, suppliers and other groups or individuals subjected towards the OIG's CMP authorization founded during 42 CFR Part 1003 can be said to be eligible for using the policy of self-reporting. SDP is not available for arrangements which are not liable under the physician self-referral law under Section 1877 of the HHS Act (N. Callender & A. Hastings, 2018). In the case of GoodHealth Inc., the investigation team found that the providers were not regularly habituated in self-reporting to their OIG regarding the issues and errors found in peer review for medical errors by physicians. Thus the director had potentially breached section 1877 and is liable for remedies under the consequences of breach.
The organization should self-report as it is vital to admit any medical error or fraudulent actions. Self reporting shall be emphasized on a timely manner so that the medical errors are addressed without any kind of misleading for the patients’ diagnosis. So, this helps to reduce the errors of the health care organization. It also helps to improve the skills of the medical practitioners by acquiring vital patient's data. Self-reporting is also very helpful to improve the working environment of health care. The main advantage of self-reporting is that the data can very easily obtain (Roger, 2020). Apart from that, the success of self-reporting is mainly dependent on various factors such as the staff of health care must remember when medical errors occur. The self-report should be very user-friendly and not very much difficult to understand. 'Just culture' principle shall be followed within the health care firm. The practitioners must focus on improving their processes and system (White, 2020). The OIG of the US Department of HHS has published the self-disclosure protocol for the healthcare providers to minimize the fraud under a health care organization. This falls under the federal health care program section 1128B(f) of the social security act and 42 U.S.C. 1320a-7b(f). This helps in reducing the frequency of errors within the medical activities of the practitioners by increasing the standard of treatment.
