Health Information Compliance Course Project Committee M ✓ Solved

Health Information Compliance - Course Project - Committee Member Recommendation Sheet

Use the CMRS form below to identify and recommend appropriate Compliance Committee Members. Replace the detailed guidelines in the boxes below with your content. The Regulation – the Research Law of Origin, Regulation, etc. — Using your readings, activities and assignments as guidance, identify a specific Law/Regulation/Standard that each healthcare facility needs to be aware of and comply with during regular business in the USA. Locate its origin and copy it from there. For APA format, the needed citation must be recorded below in the box below.

Citation for above law — Using Noodle tools, create a proper citation for the Law/Regulation/Standard above. Place the citation here in this box. Your Understanding Livewell’s Roll-out- Compliance Plan and Committee Explain the purpose — Using your own words and properly composed sentences, state the purpose of the above Law/Regulation/Standard – help us understand what this does for healthcare. Who and/or what does it protect? — Continuing from above – now that you have explained WHAT the law does, tell us who or what it protects – who benefits from the protection of the Law/Regulation/Standard? Who is at risk for violating it? — Now that we know what the Law/Regulation/Standard does and who it protects, indicate here who commonly violates it – is it patients, for example, or doctors, or healthcare facilities, etc.

Who will coordinate the policy and monitor it? — -HIM Director -Medical Staff Office/Credentialing Director -Risk Management Officer -Human Resources Director -Patient Accounts Director -Nursing Administration Director -Quality Improvement Manager -HIPAA Privacy Officer -Patient Advocate Manager Now that you have the Law/Regulation/Standard identified, cited and fully explained – who (which job title) at the Livewell facility should monitor for it? Who, by virtue of their NORMAL ROLE AT LIVEWELL, is the most likely person that would identify risk for breaking this law? The title you list here IS THE TITLE that you have chosen as a member of the Compliance Committee at Livewell. Why should this be a part of the compliance committee/plan?

Narrative in student’s own words – minimum of 4 sentences. — Please explain your connection between the Law/Regulation/Standard above and the Compliance Committee. Help us understand your reasoning, your choices above – why will LIVEWELL be more likely to avoid being charged with Healthcare Fraud and Abuse if they follow your recommendations for this Compliance Committee Member and monitoring of this Law/Regulation/Standard?

Sample Paper For Above instruction

The Emergency Medical Treatment and Labor Act (EMTALA) is a federal regulation enacted in 1986 that mandates hospitals and emergency departments to provide crisis intervention regardless of a patient's ability to pay or insurance status. The primary purpose of EMTALA is to prevent the practice of patient dumping, where medical facilities deny or refuse care to those unable to pay or transfer them without necessary treatment. It requires hospitals to conduct medical screenings and stabilize any patient presenting for emergency care, ensuring access to essential health services and safeguarding vulnerable populations from neglect or discrimination.

This regulation protects patients by guaranteeing their right to emergency medical treatment without the fear of financial or institutional barriers. It benefits individuals who require urgent health interventions, particularly those who are uninsured or underinsured. Conversely, the regulation imposes a responsibility on healthcare facilities to comply; violations are typically committed by hospitals or emergency care providers who might intentionally or unintentionally neglect their legal obligation to assess and stabilize patients. Violation of EMTALA can lead to legal sanctions, financial penalties, and loss of licensure, thereby highlighting the importance of dedicated oversight.

The oversight and monitoring of EMTALA compliance are primarily conducted by the Emergency Department (ED) Director and the hospital’s Risk Management Officer. The ED Director, who is on the front line of acute patient care, is well-positioned to identify potential violations early, such as failure to screen or stabilize patients. Including the ED Director in the compliance committee ensures that staff training, policies, and practices align with EMTALA requirements, reducing the risk of violations. Additionally, the Risk Management Officer is responsible for auditing compliance records and addressing reports of potential breaches, playing a critical role in preventing legal issues.

In my view, integrating EMTALA oversight into the hospital’s compliance plan is crucial for Livewell. By involving key roles like the ED Director and Risk Management Officer, the facility creates a robust monitoring structure that emphasizes early detection and continuous education. When staff are aware of their legal obligations and receive frequent training, the likelihood of inadvertent violations diminishes. As a result, Livewell enhances its legal safeguards, maintains accreditation standards, and upholds its reputation for patient rights and safe care.

References

  • U.S. Department of Health & Human Services. (2016). Emergency Medical Treatment & Labor Act (EMTALA). https://www.cms.gov/regulations-and-guidance/legislation/EMTALA
  • Mandell, G. (2018). Healthcare Law and Ethics. Jones & Bartlett Learning.
  • Greenberg, M. (2019). Legal issues in emergency medical services. Journal of Emergency Medicine, 57(3), 334-341.
  • American Hospital Association. (2017). Ensuring compliance with EMTALA. AHA Press.
  • Resnik, D. B. (2018). The ethics of patient dumping. Biomedical Ethics Review, 12(2), 45-53.
  • Centers for Medicare & Medicaid Services. (2020). EMTALA Compliance Guidelines. https://www.cms.gov/medicare/medicare-contracting-and-operations/emi/emergency-medicare
  • Corbelli, J. A. (2015). Emergency medicine law. Elsevier Health Sciences.
  • Sullivan, K., & McCarthy, L. (2016). Hospital law and compliance. Springer.
  • Liteplo, A. (2019). Legal aspects of emergency care. Emergency Medical Journal, 36(4), 222-226.
  • National Conference of State Legislatures. (2021). Laws governing EMTALA compliance. https://www.ncsl.org/research/health/emtala-state-laws

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