Health Care Organizations, Finance, and Regulation

Catalog description

This course will introduce students to legal issues associated with the financing of health care (both public and private payment systems), as well as the forms and structures of modern health care organizations, including the creation and regulation of tax-exempt organizations and how the antitrust laws impact the structure and conduct of health care providers. The course will also cover the federal and state laws that impose criminal and civil penalties on health care providers for a variety of activities. Coverage will include the five main Federal fraud and abuse laws: the False Claims Act, the Anti-Kickback Statute, the Stark Law, the Exclusion Statute, and the Civil Monetary Penalties Law, as well as an introduction to the Foreign Corrupt Practices Act. Discussions will include how health care businesses can comply with these laws in their relationships with payers (e.g., the Medicare and Medicaid programs), vendors (e.g., drug, biologic, and medical device companies), and fellow providers (e.g., hospitals, nursing homes, and physician colleagues). These areas will be reviewed both from the perspective of compliance and transactional issues. The course will also cover labor and employment issues and management of patient safety issues.