The Law of Health Care Organization and Finance
The Law of Health Care Organization and Finance

Author: Barry R. Furrow

Publisher: West Academic Publishing

Published: 2013

Total Pages: 0

ISBN-13: 9780314279910

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This book is designed for a specialized health law course focusing on the organization and finance of health care. It is also well-suited for health law courses in health administration or management programs. The 7th Edition focuses heavily on the many changes that the Affordable Care Act is bringing about in the regulation of health care and health insurance. The book begins with an introduction to fundamental concepts affecting health law and policy, and then explores conventional and emerging methods of quality control regulation applicable to health care professionals and health care institutions. The next section of the book examines in depth the policy and legal issues presented by varying approaches to providing access to health care and controlling its cost. This section explores in depth the provisions of the Affordable Care Act that are expanding access to health care, and analyzes the challenges to that law, including the National Federation of Independent Business Supreme Court decision. This section also considers legal issues presented by private health insurance, managed care, Medicare, and Medicaid, as well as obligations to provide medical services under state and federal law. The final section of the book explores legal issues that affect health care institutions and the relationships between professionals and institutions, including medical staff privileging, physician-hospital contracting, accountable care organizations, employment and labor law, tax exempt organization law, fraud and abuse issues, and antitrust law. The 7th edition has been completely updated, covering recent developments involving consumer-driven health care, ERISA, antitrust enforcement, labor law, and tax-exempt organization law, in addition to the Affordable Care Act developments.

The Law of Health Care Organization and Finance
The Law of Health Care Organization and Finance

Author: Brietta R. Clark

Publisher: West Academic Publishing

Published: 2022-05-02

Total Pages: 933

ISBN-13: 9781684677139

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This book is designed for a specialized health law course focusing on the organization and financing of health care. It is also well-suited for health law courses in health administration, business, or health policy and management programs. The book begins with an introduction to fundamental concepts affecting cost, quality, access, and equity in health care and sets out the economic principles and tools used in health policy and reform efforts. The book includes extensive coverage of payment systems, including Medicare, Medicaid, and private insurance and their effect on the organization of the health care delivery system, including alternative payment models, such as accountable care organizations. The book also surveys the organizational structures and legal relationships in health care enterprises. The book explores legal concerns affecting the payment and delivery of health care, including the continuing impact of the Affordable Care Act, up-to-date coverage of fraud and abuse laws, antitrust enforcement, ERISA, and requirements for tax-exempt entities. Several chapters examine the legal framework for quality control efforts, including professional licensure, institutional licensure and certification, and nondiscrimination requirements. As in previous editions, the authors provide classroom teaching tools including problems that engage students in dealing with legal, policy, and practical issues and a range of materials drawn from judicial opinions, statutes, regulations, agency guidance, and other sources.

The Law of Health Care Finance and Regulation
The Law of Health Care Finance and Regulation

Author: Mark A. Hall

Publisher: Aspen Publishing

Published: 2018-05-11

Total Pages: 907

ISBN-13: 154380473X

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The Law of Health Care Finance and Regulation is based on Part III, “Institutions, Providers, and the State,” of parent book Health Care Law and Ethics and adds additional coverage of a variety of issues that have shaped health care finance law. Integrating public health, financial and ethical issues, this casebook uses compelling case law, clear notes and comprehensive background information to illuminate the complex and dynamic field of health care law. Key Features: Based on material in Part III of the popular parent book, “Institutions, Providers, and the State,” along with coverage of duty to treat, hospital liability, managed care liability, and regulating access to drugs. Includes cases and material not found in the parent book on: • Judicial and administrative review of Medicare decisions. Certificate of need laws. Review immunity. Integrates public health and ethics issues and features clear notes that provide context, smooth transitions between cases, and background information. Website provides background materials, updates of important events, additional relevant topics and links to other resources on the Internet.

Essentials of Health Care Organization Finance
Essentials of Health Care Organization Finance

Author: Dennis D. Pointer

Publisher: John Wiley & Sons

Published: 2004-09-24

Total Pages: 207

ISBN-13: 0787976504

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"Finally! The book that all health care board members needed but were afraid to ask for! Those dark days of staring at incomprehensible numbers during board meetings, of nervous nodding when their financially-literate brethren make comments or ask questions, of voting on things that they do not understand are gone! This book is long overdue and should be read by every trustee who is not a finance professional." --James E. Orlikoff, president, Orlikoff & Associates, Inc. and executive director, American Governance & Leadership Group Accounting for $1.4 trillion in expenditures (13.7 percent of gross domestic product), health care is one of the nation's largest and fastest growing industries. This concise, expertly written primer on health care organization finance is a nuts and bolts guide to what has become every hospital's most sensitive topic. Health care organization board members must possess basic financial competence to govern effectively. This book will help them acquire, easily and painlessly, the basic financial literacy essential for discharging their roles and fulfilling their fiduciary duties.

Financial Management of Health Care Organizations
Financial Management of Health Care Organizations

Author: William N. Zelman

Publisher: John Wiley & Sons

Published: 2009-09-28

Total Pages: 686

ISBN-13: 0470522917

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Thoroughly revised, this third edition of Financial Management of Health Care Organizations offers an introduction to the most-used tools and techniques of health care financial management. Comprehensive in scope, the book covers a broad range of topics that include an overview of the health care system and evolving reimbursement methodologies; health care accounting and financial statements; managing cash, billings, and collections; the time value of money and analyzing and financing major capital investments; determining cost and using cost information in decision-making; budgeting and performance measurement; and pricing. In addition, this new edition includes information on new laws and regulations that affect health care financial reporting and performance, revenue cycle management expansion of health care services into new arenas, benchmarking, interest rate swaps, bond ratings, auditing, and internal control. This important resource also contains information on the 2007 Healthcare Audit Guide of the American Institute of Certified Public Accountants (AICPA). Written to be accessible, the book avoids complicated formulas. Chapter appendices offer advanced, in-depth information on the subject matter. Each chapter provides a detailed outline, a summary, and key terms, and includes problems in the context of real-world situations and events that clearly illustrate the concepts presented. Problem sets that end each chapter have been updated and expanded to support more in-depth learning of the chapters’ concepts. An Instructor’s Manual, available online, contains PowerPoint and Excel files.

The Law of Tax-Exempt Healthcare Organizations
The Law of Tax-Exempt Healthcare Organizations

Author: Thomas K. Hyatt

Publisher: John Wiley & Sons

Published: 2012-05

Total Pages: 254

ISBN-13: 1118037499

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Authoritative and entirely up to date to reflect recent changes in health law and tax-exempt law, this is a one-volume source of detailed information on federal, state, and local laws covering tax-exempt healthcare organisations.

Health Care Finance and the Mechanics of Insurance and Reimbursement
Health Care Finance and the Mechanics of Insurance and Reimbursement

Author: Michael K. Harrington

Publisher: Jones & Bartlett Learning

Published: 2019-10-01

Total Pages: 344

ISBN-13: 1284169030

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Health Care Finance and the Mechanics of Insurance and Reimbursement stands apart from other texts on health care finance or health insurance, in that it combines financial principles unique to the health care setting with the methods and process for reimbursement (including coding, reimbursement strategies, compliance, financial reporting, case mix index, and external auditing). It explains the revenue cycle in detail, correlating it with regular management functions; and covers reimbursement from the initial point of care through claim submission and reconciliation. Thoroughly updated for its second edition, this text reflects changes to the Affordable Care Act, Managed Care Organizations, new coding initiatives, new components of the revenue cycle (from reimbursement to compliance), updates to regulations surrounding health care fraud and abuse, changes to the Recovery Audit Contractors (RAC) program, and more.

Introduction to U.S. Health Policy
Introduction to U.S. Health Policy

Author: Donald A. Barr

Publisher: JHU Press

Published: 2011-12-01

Total Pages: 659

ISBN-13: 1421402971

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Health care reform has dominated public discourse over the past several years, and the recent passage of the Affordable Care Act, rather than quell the rhetoric, has sparked even more debate. Donald A. Barr reviews the current structure of the American health care system, describing the historical and political contexts in which it developed and the core policy issues that continue to confront us today. This comprehensive analysis introduces the various organizations and institutions that make the U.S. health care system work—or fail to work, as the case may be. A principal message of the book is the seeming paradox of the quality of health care in this country—on the one hand it is the best medical care system in the world, on the other it is one of the worst among developed countries because of how it is organized. Barr introduces readers to broad cultural issues surrounding health care policy, such as access, affordability, and quality. He discusses specific elements of U.S. health care, including insurance, especially Medicare and Medicaid, the shift to for-profit managed care, the pharmaceutical industry, issues of long-term care, the plight of the uninsured, medical errors, and nursing shortages. The latest edition of this widely adopted text updates the description and discussion of key sectors of America’s health care system in light of the Affordable Care Act.