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

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Print Book :Softboud, 870 pages
1st Edition
ISBN: 9781632813480
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ISBN: 9781632813770
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1st Edition
ISBN: 9781632813770
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The tremendous growth of hospitals and health systems in the United States was spurred on after World War Two with passage of the Hill-Burton Act, which funded the construction of new facilities, and the Social Security Act of 1965, which established Medicare and Medicaid and greatly expanded the number of people who have some form of health insurance. The universe of hospitals and health systems began to grow and evolve, and continues to do so. This new Handbook examines the multitude of issues that those who represent hospitals and health system need to be informed about but will also be a critical guide for those who represent physicians, diagnostic imaging facilities, other health care facilities, as well as financial institutions.

Coverage Includes:

      •   Establishment of facilities;
      •   State licensing requirements;
      •   Certification process;
      •   Payment methodologies;
      •   State and Federal fraud and abuse regulations; and
      •   Operational issues, including patient relations, privacy, grievance rights, and consent to treatment

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, First Edition an indispensable resource.

Authors / Contributors

Table of Contents

 PART 1   Background and History


Chapter 1   Background and History



PART 2   Establishing and Maintaining Hospitals


Chapter 2   Licensure, Certification and Related Requirements

Chapter 3   Medicare Enrollment and Certifications



PART 3   Sources of Revenue-Payment for Hospital Services


Chapter 4   Sources of Revenue


Chapter 5   Medicare Payment Adjustments


Chapter 6   Rural Hospitals and Other Providers


Chapter 7   Other Medicare Payment Issues


Chapter 8   Medicare Provider-Based Status


Chapter 9   Medicare Audits and Appeals Process


Chapter 10   Medicare and Medicaid Alternative Payment Models


Chapter 11   Medicaid


Chapter 12   Private Payers


Chapter 13   The Uninsured and Underinsured




PART 4   Fraud and Abuse Principles for Hospitals


Chapter 14   Federal Fraud and Abuse Laws



Chapter 15   State Fraud and Abuse Laws



Chapter 16   Fraud and Abuse Issues Unique to Hospitals



Chapter 17   Compliance with Fraud and Abuse Laws




PART 5   Relationships with Physicians


Chapter 18   Common Arrangements with Physicians



Appendix 18A   Duties of Medical Director, Surgical Intensive Care Unit


Chapter 19   Hospital-Physician Alignment Strategies



Chapter 20   Medical Staff Issues



PART 6   Hospital Operational Issues


Chapter 21   Patient Relations



Chapter 22   EMTALA



Chapter 23   Risk Management



Chapter 24   Privacy and Medical Records


Chapter 25   Telehealth-The Newest Age of Health Care Delivery



Appendix 25.1   Telemedicine Credentialing Agreement


Chapter 26   Hospital Contracting Issues


Chapter 27   340B ISSUES


Chapter 28   Clinical Research



PART 7   Transactions


Chapter 29   TRANSACTIONS





PART 8   Integrated Health Systems


Chapter 30   Other Providers



PART 9   Miscellaneous


Chapter 31   Academic Medical Centers



Chapter 32   Public Hospitals



Chapter 33   Children's Hospitals



Chapter 34   Antitrust Issues For Hospitals And Health Systems



Chapter 35   Tax Issues



Appendix 35A   Hospital Joint Venture Policy

Appendix 35B   Hospital Calendar Year 2015 Conflict of Interest and Disclosure Statement for Board of Trustees, Officers and Key Employees

Appendix 35C   Flowchart for Application of Rev. Proc. 97-13


Chapter 36   Governance



Chapter 37   Labor and Employment


Chapter 38   Real Estate Issues