this is a discussion not a paper I need 2 paragraphs under each statement each paragraph about 250 words with up to date references.
this is the scenario
HSA515 Week 4 Scenario Script: Health Care Policy, Law, and Ethics – Civil Procedures, Practices and Corporate Structure
Slide # Scene/Interaction Narration
Slide 1 Scene 1: Exterior Strayer University Building/Classroom
Slide 2 Scene 2
Professor Charles enters classroom and introduces the topics for today’s lesson and begins the lecture. Prof Charles: Hello everyone….welcome back to class. Today, we are going to discuss civil procedures, practices, and corporate structure.
Trials, especially jury trials, are vital to fostering the respect of the public in the civil justice system. Trials do not represent the failure of the system. This class is important in understanding the law as it applies to the courtroom. Although many of the procedures leading up to and followed during a trial will be discussed, civil procedures and trial practice are governed by each state’s statutory requirements. Cases on a federal level are governed by federal statutory requirements.
The pleadings of a case are the written statements of fact and law filed with a court by the parties to a lawsuit. The complaint is the first pleading in a lawsuit that is filed by the plaintiff. A demurrer is a pleading filed by a defendant challenging the legal sufficiency of a complaint. An answer to a complaint is a pleading, which admits or denies the specific allegations set forth in the complaint and constitutes a general appearance by a defendant. A bill of particulars is a request for a written itemization of the claims, which a defendant can demand from the plaintiff to determine what the details of a claim are. A defendant may also file a cross-compliant and bring other parties into a law suit by the process.
Let’s first discuss the summons and complaint. Who can tell us what a summons and a complaint are?
Casey: A summon is a service of process on a defendant and a return to the court of that process by the person who served it. In other words, it is when an issue has been called in the courts to come back together. And, Wow, a complaint is any formal legal document that is issued by the plantiff to hopefully supports a claim against someone or a group.Donald: A first pleading filed with the court in a negligence action is the complaint. The complaint identifies the parties to a suit, states a cause of action, and includes a demand for damages. The complaint is filed by the plaintiff and is the first statement of a case by the plaintiff against the defendant.
Prof. Charles: Absolutely… What specific formalities must be observed in the service of a summons for proper jurisdiction?
Casey: The formalities dictate the manner in which a summons is to be delivered, the period within which service must be effected, and the geographical limitations which service must be made. Where the service cannot be possible, the action may have to be brought into a different court.
Prof. Charles: What may the defendant do to defeat the plaintiff’s complaint initially?
Donald: In the preliminary motions, the defendant may cite possible errors that would defeat the plaintiff’s case stating the summons was served improperly, that the action was brought in the wrong jurisdiction, or that there was something technically incorrect in the complaint.
Prof. Charles: Great job Donald! Now let’s take a closer look at how the defendant may file a counterclaim.
Slide 3 Check Your Understanding
Which of the following is a demurrer?
A. Pleading of facts.
B. Formal objection by defendant to a lawsuit.
C. A bill of particulars.
B. A demurrer is a formal objection by one of the defendant to a lawsuit that the evidence presented by the plaintiff is insufficient to sustain the case.
Slide 4 Scene 3
Prof. Charles: Discovery is the process of investigating the facts of a case before trial.
The objective of discovery to obtain information and facts and gather evidence about the case in preparation for trial. It is the principal fact-finding method in the litigation process.
Discovery rules were developed to prevent trial by ambush. To deny a party the right to know all witnesses to be called to testify before trial is an insult to this principle. A deposition is a discovery technique used by parties to learn more regarding the nature and substance of each other’s case.
Confidential communications made by a client and an attorney to one another are protected by attorney-client privilege.
Who can tell the class what the three elements required to successfully assert attorney-client privilege?
Donald: Professor Charles, the first element is both parties must agree that the attorney-client relationship does or will exist. The second is the client must seek advice from the attorney; and third, communications between the attorney and client must be identified to be confidential.
Prof. Charles: Impressive! Now, let’s discuss the role of the expert witness. The expert witness is one who is accepted by the court as having the training, skills, experience, and education to inform the jury and court on knowledge outside the experience of the average jury and court.
Casey: Just to be clear, is the expert qualified based on his/her training, skills, education, and experience in the technical issues or special knowledge areas concerning the facts of the case?
Prof. Charles: Yes and the expert witness’ qualifications to be an expert are explained to the court. When two experts in a trial disagree, the jury will decide which one to believe. The jury determines the facts in a case and makes a determination of the particular standards of conduct required in all cases in which the judgment of reasonable people might differ.
Now, let’s turn to the responsibilities of the healthcare corporation as well as legal risks. Most healthcare organizations operate as corporations, although some are sole proprietorships or partnerships. Generally, the authority of a corporation is expressed in the law under which the corporation is chartered and in the articles of incorporation. The existence of this authority creates certain duties and liabilities for governing boards of trustees or directors and their individual members.
Casey: So, the hospital Board has a responsibility to provide a safe environment for the patient?
Prof. Charles: Yes. The corporate negligence doctrine imposes on hospitals an implied duty to patients to select competent physicians, who, even though they are independent practitioners, would be providing hospital care to their patients though staff privileges.
The hospital assumes the duty of supervising the competence of its physicians. The hospital which does not supervise its physicians to prevent patient harm or injury is liable for corporate negligence. Ideally, the corporate body conducts its business and physician supervision through a variety of committees. Some of these committees are the Executive Committee, the Finance Committee, the Joint Conference Committee, and the Planning Committee.
Slide 5 Check Your Understanding
One of the ways of restoring trust in the physician, the hospital, and the insurer is to ____________.
A. Inform patients of their rights and responsibilities.
B. Conduct yourself in a pleasant manner.
C. Offer professional discounts.
D. Provide reviews and rating of the facility and staff.
A. Inform patients of their rights and responsibilities are one of the ways of restoring trust in the physician, the hospital, and the insurer.
Slide 6 Check Your Understanding
The benchmark case in the healthcare field that has had a major impact on the liability of healthcare organizations, Darling v. Charleston Community Memorial Hospital, enunciated the doctrine of ______________.
A. Respondeat superior.
B. Corporate scrutiny
C. Corporate negligence
C. The benchmark case in the healthcare field that has had a major impact on the liability of healthcare organizations, Darling v. Charleston Community Memorial Hospital, enunciated the doctrine of Corporate negligence.
Slide 7 Scene 4
Discussion of Governing Body Responsibilities Prof. Charles: Now let’s continue our discussion of the duties ascribed to the individual members of the governing body.
Can anyone give some examples of the governing body’s duty to act responsibly?
Casey: I think I can name a few. The governing body is responsible for selecting the hospital CEO to act as their agent in the management of the hospital. The governing body is responsible for obeying all state, local, and federal laws, and compliance with accreditation standards of accrediting bodies.
Prof. Charles: Very good, Casey! Those are all great examples.
Donald: Prof. Charles…what about conflicts of interest involving board members?
Prof. Charles: Donald, that is a great question…. a conflict of interest involves those situations in which a person has an opportunity to promote self-interests that could have a detrimental effect on an organization with which he or she has a special relationship, for example an employee or board member. The potential for conflict of interest exists for individuals at all levels within an organization. Each board member must submit in writing all possible or actual conflicts of interest. Membership on the governing body of a public organization must not be for private gain.
Casey: So, is it safe to say conflict of interest is presumed to exist when a board member or a firm with which he or she is associated with may benefit or lose from the passage of a proposed action?
Prof. Charles: Yes, Casey. I believe that is a pretty good distinction.
Donald: I think that the discussion on governing body responsibilities has really clarified some questions for me. I would still like to know a little more about how health care boards should structure financial arrangements to avoid liabilities with the federal government.
Prof. Charles: Well, that is a great lead-in to the next topic, which is Safe-Harbor Regulations.
Slide 8 Scene 5
Discussion on increase in assets and decrease in liabilities. Prof. Charles: Healthcare service organizations must comply with Safe Harbor Regulations to avoid or be exempt from prosecution by the Federal Trade Commission and the Department of Justice, which is commonly called (DOJ). The federal law became effective on July 9, 1991. The law forbids health providers to be obligated to refer business to business ventures or to have an investment tied to business referrals. Illegal remunerations or kickbacks are a felony under the law. Safe Harbor regulations are published by the DOJ and violations can result in civil or criminal sanctions, as well as exclusion from Medicare and Medicaid programs.
Who can give an example of a Safe Harbor regulation?
Donald: The Safe Harbor prohibits a hospital to pay an employee, who has no real genuine employment relationship with the hospital, for providing non-covered items or services.
Prof. Charles: Exactly… A health plan can offer price reductions to a hospital as long as both comply with all of the applicable standards.
Legal counsel and the Chief Compliance Officer must be involved in all matters affecting Safe Harbor regulations.
Casey: Professor, in our discussion, you have provided us with a significant amount of information about corporate responsibility.
Since we are on this subject, I would like for you to talk about board responsibility and antitrust safety.
Prof. Charles: The DOJ and the Federal Trade Commission have issued policy statements designed to educate and instruct healthcare board members on issues surrounding mergers and joint ventures. These statements outline the analysis the federal agencies will use to review conduct that falls outside antitrust safety zones. The issues pertaining to these antitrust safety zones have to do with mergers and joint ventures, hospital participation in exchange of price and cost information, physician network joint ventures, joint purchasing arrangements among healthcare providers, and hospital joint ventures involving high-technology or other expensive medical equipment.
Federal agencies are available to review potential conduct that falls outside antitrust safety zones and advise health providers on possible violations.
Donald: So, the federal agencies are available to help health providers avoid possible violations?
Prof. Charles: Yes, Donald, the federal agencies have a timetable to respond to health provider’s requests for advice on prohibited remuneration and safe-harbor statutory schemes.
Slide 9 Scene 6
Prof Charles: We are just about near the end of the day. Let’s go over what we learned in this lesson.
Today, our discussion focused on the civil procedure, trial practice, and corporate structure. We learned about the various procedures leading up to and following a trial and the role of state and federal governments.
We also reviewed the role of the governing body in overseeing and controlling the corporation’s activities. There was further discussion of the role of the health service organization’s responsibility for providing a safe patient environment. Antitrust laws and standards were addressed declaring patients have free choice of goods and services so that health providers can protect themselves from anti-competitive activities and antitrust claims.
Before we adjourn, are there any questions?
Donald: I have no questions; I think that the information was clearly presented, Professor.
Casey: No questions for me. I enjoyed today’s lesson and I look forward to next week.
Professor Charles: That’s good to hear. Enjoy your day and I will see you next time. Please take the time to complete the threaded discussions for this week.
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