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AHLA Representing Hospitals and Health Systems Handbook (Non-Members)

All health attorneys and others in the health care field who need to understand the intricacies and complexities of hospitals and health systems will find Representing Hospitals and Health Systems Handbook, Second Edition an indispensable resource.

Publisher: AHLA

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Print Book:Softbound, 912 pages
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ISBN/ISSN: 9781663395856
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ISBN/ISSN: 9781663395870
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ISBN/ISSN: 9781663395870
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Product description

Despite the monumental changes that have occurred in the American health care delivery system since publication of this book’s previous edition, hospitals remain at the center of the storm. Although the relationship between a hospital and its physicians remains a key concern, the nature of that relationship has changed, taking a variety of forms that trigger more complex legal and practical implications. New risks have emerged as a result of evolving care models (e.g., direct contracting) and types of care (e.g., telehealth).

As a result, effective representation of hospitals and health systems requires familiarity with a broader array of legal concerns at both the federal and state levels. This publication represents our work, and the work of many volunteer authors, toward the goal of providing both an orientation and in-depth hands-on practice guide that covers the full range of topics related to hospital-based health care

To help readers navigate the sea of applicable law, this completely updated and wholly reorganized second edition of Representing Hospitals and Health Systems contains thirty-six chapters, organized into six parts:

Part I Establishing and Maintaining Hospitals
Part II Payment for Hospital Services
Part III Fraud and Abuse Issues for Hospitals
Part IV Hospital Operational Issues
Part V Considerations for Specialized Settings
Part VI Other Selected Topics

Within the chapters, experienced practitioners describe the relevant legal framework and provide insight into both legal and operational impacts, as well as techniques for managing them.

Representing Hospitals and Health Systems is recommended to everyone who needs a thorough understanding of the complex legal, payment, and policy mechanisms that govern hospitals and health systems. This publication will serve as a critical guide, not only for those who represent these central entities, but also for those who represent physicians, ancillary care providers, and the wide variety of stakeholders that provide or receive services related to the provision of hospital care.

EDITORS: Emily Black Grey, Travis G. Lloyd, Susan O. Scheutzow and Claire M. Turcotte

AUTHORS: Stephen M. Angelette, Alexis L. Angell, Evelyn S. “Evie” Atwater, Thomas Barker, Marie Berliner, Deborah Biggs, Ryan P. Blaney, Kelly A. Carroll, Dominic Castillo, Richard Y. Cheng, Allison M. Cohen, Sven C. Collins, Hannah Comeau, Emily Cook, Amanda Coulter, Bradley Cunningham, Audrey Davis, Jeffrey I. Davis, Lisl J. Dunlop, Andrea Ferrari, Jon Ferry, Alissa D. Fleming, Caitlin Forsyth, Larry Gage, Joseph V. Geraci, Dexter R. Golinghorst, Adam H. Greene, Mary Grace Griffin, Stephanie Gross, Pete Herrick, Daniel J. Hettich, Stephanie M. Hoffmann, John Holdenried, Ann Hollenbeck, Robert G. Homchick, Louise Joy, Joseph Keillor, Jason J. Krisza, Sandi Krul, Michael S. Lemell, Amy Lerman, Jeffrey Lin, Tony R. Maida, Wendy Maneval, Ross D. Margulies, Jason T. Mayer, Lyndsay Medlin, Elizabeth Mills, Goran Musinovic, Robert R. Niccolini, Mark Ogunsusi, Karen R. Palmersheim, Arthur E. Peabody, Michael W. Peregrine, Alek Pivec, Caroline Reignley, Brad Robertson, Robert L. Roth, Deborah Samenow, Michael F. Schaff, Alaap Shah, Jacob S. Simpson, Heather H. Sveadas, Regan Tankersley, Adrienne A. Testa, Bruce J. Toppin, Vincent Torres, Cori Casey Turner, David J. Vernon, William H. von Oehsen III, Jody Ward-Rannow, David A. Weil, Tracy Weir, Barbara Straub Williams, Cynthia F. Wisner, Virginia Wright, Jeff J. Wurzburg, Hilary Young

For full author bios, click here.

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Published November, 2024.

 

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Table of contents

PART I  Establishing and Maintaining Hospitals
Chapter 1  A History of Hospitals and Medicare Enrollment
Chapter 2  State Licensure, Certification, and Related Requirements
Chapter 3  Certificates of Need
Chapter 4  Hospital Accreditation

PART II  Payment for Hospital Services
Chapter 5  Medicare Hospital Payment Basics
Chapter 6  Medicare Payment Adjustments
Chapter 7  Medicare Provider-Based Status
Chapter 8  340B Issues
Chapter 9  Medicare Audits and Appeals Process
Chapter 10  Medicare and Medicaid Alternative Payment Models
Chapter 11  Medicaid
Chapter 12  Private Payers
Chapter 13  Surprise Billing and Price Transparency Issues

PART III  Fraud and Abuse Issues for Hospitals
Chapter 14  Overview of Fraud and Abuse Laws
Chapter 15  Special Considerations for the Hospital Setting
Chapter 16  Financial Relationships with Physicians and Other Referral Sources
Chapter 17  Fraud and Abuse Investigations and Enforcement Actions

PART IV  Hospital Operational Issues
Chapter 18  Compliance with Fraud and Abuse Laws
Chapter 19  Patient Relations
Chapter 20  Risk Management
Chapter 21  EMTALA
Chapter 22  Medical Staff Issues
Chapter 23  Health Information Privacy and Security
Chapter 24  Telehealth
Chapter 25  Clinical Research
Chapter 26  Hospital Perspectives on Medical Cannabis
Chapter 27  Disasters and Public Health Emergencies

PART V  Considerations for Specialized Settings
Chapter 28  Academic Medical Centers
Chapter 29  Rural Hospitals
Chapter 30  Public Hospitals
Chapter 31  Children’s Hospitals

PART VI  Other Selected Topics
Chapter 32  Governance
Chapter 33  Antitrust Issues for Hospitals and Health Systems
Chapter 34  Tax Issues
Chapter 35  Labor and Employment Matters
Chapter 36  Real Estate Issues

TABLE OF CASES
INDEX