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Tables of Contents for Healthcare Law and Ethics
Chapter/Section Title
Page #
Page Count
Acknowledgments
xv
The Puzzle to Solve
1
12
Analyzing the Legal and Ethical Issues
4
1
The Goals of This Book
5
1
The Different Meanings of Ethics in the Healthcare Field
6
7
PART I WHAT IS LAW, AND HOW DOES IT WORK?
The American Legal System
13
16
Who Makes the Laws, and Who Changes the Laws?
13
3
Substantive Areas of Law
16
2
State and Federal Court Systems
18
4
The Process of a Civil Lawsuit
22
7
The Plaintiff's Complaint and Summons
22
1
The Defendant's Answer or Motion to Dismiss
22
2
Discovery
24
1
Pretrial Motions Such as Motion for Summary Judgment
25
1
The Trial
26
1
Posttrial Motions
26
1
The Appeal
26
3
How to do Legal Research
29
14
Understanding Legal Citation Form
30
4
Citations to Case Law
30
2
Citations to Statutes and Regulations
32
2
How to Find Legal Materials in the Easiest Possible Way
34
9
Federal Legislation
35
2
Federal Regulations
37
1
Federal Cases
38
1
State Law Materials
38
5
PART II MANAGING AND REGULATING THE BUSINESS OF HEALTHCARE
The Legal Structure of Healthcare Providers
43
20
The Law of Corporations
44
4
What Is a Corporation?
44
1
Pros and Cons of the Corporate Form
44
3
Who Controls a Corporation?
47
1
Healthcare Providers as Legal Entities
48
5
Public Facilities
48
1
Private, Nonprofit Facilities
49
2
For-Profit Facilities
51
2
Current Issues and Trends in Legal Structure and Ownership
53
10
The Purchase of Public and Nonprofit Facilities
55
3
Conversion from Nonprofit to For-Profit Status
58
1
Joint Ventures
59
4
Government Regulation of Healthcare Services
63
24
Government Regulation for Quality of Care
66
4
Licensure of Individual Healthcare Professionals
66
1
Licensure of Healthcare Facilities
67
1
Accreditation of Healthcare Facilities
67
1
Certification for the Medicare and Medicaid Programs
68
1
Government Regulation of Diversified Organizations
69
1
Government Regulation for Cost Containment and Access
70
11
The Purposes and Effects of CON Laws
70
2
The System of CON Regulation
72
2
The Medical Arms Race
74
7
Government Regulation of Insurance for the Protection of the Consumer
81
6
State Regulation of Insurance Companies and HMOs
82
1
The Problem of Extending Access to Coverage
83
4
Medical Staff Membership and Clinical Privileges
87
12
The Relationship Between Physicians and Hospitals
88
2
The Organized Medical Staff
90
3
Denial or Termination of Membership and Privileges
93
2
Judicial Review of Credentialing Decisions
95
4
The Law of Government Payment Programs: Medicare, Medicaid, and Fraud and Abuse
99
38
The Medicare Program
100
8
The Structure of the Program
100
1
Medicare Payment Issues
101
2
Medicare Managed Care and the New Part C
103
5
The Medicaid Program
108
6
The Structure of the Program
108
1
Eligibility for Medicaid
109
1
Medicaid Benefits
110
3
Medicaid Payment Issues
113
1
Fraud and Abuse
114
23
False Claims
115
4
Kickbacks
119
8
Self-Referrals
127
4
Compliance Programs for Healthcare Providers
131
6
Antitrust Law in the Healthcare Field
137
32
Introduction to Antitrust
137
2
The Federal Antitrust Laws
139
5
The Major Categories of Antitrust Violation
139
1
The Major Federal Antitrust Statutes
140
4
Specific Areas of Antitrust Concern in the Healthcare Industry
144
25
Mergers and Acquisitions
144
6
Medical Staff Membership and Clinical Privileges
150
4
Provider Networks and Integrated Delivery Systems
154
15
PART III PATIENT-CARE ISSUES
The Law of Tort Liability
169
24
Medical Malpractice
170
13
The Tort of Negligence
170
1
Imposing Negligence Liability on the Institution or Organization
171
3
Malpractice in the System of Managed Care
174
2
Liability for Disclosure or Failure to Disclose Confidential Information
176
7
Informed Consent
183
3
Proposals for Medical Malpractice Reform
186
7
The Need for Reform in the Current System
186
1
Advantages and Disadvantages of Various Proposals for Reform
187
6
Legal and Ethical Obligations to Provide Care
193
20
The Traditional Common Law Rules for Doctors and Hospitals
194
2
The COBRA Anti-Dumping Law (EMTALA)
196
9
The Legal Basis for the Law
196
2
The Requirements of the Law
198
2
Enforcement of the Law
200
5
Prohibitions Against Discrimination
205
8
Legal and Ethical Issues in Termination or Refusal of Care
213
20
The Right to Refuse Treatment
214
6
The Right to a Natural Death
220
7
Physician-Assisted Suicide
227
6
Human Reproduction
233
18
Sterilization
234
3
Contraception and Abortion
237
9
Maternal-Fetal Conflict
246
5
PART IV LEGAL AND ETHICAL ISSUES IN MANAGED CARE
Selective Contracting With Providers
251
16
How the New System Works
254
1
Legal Issues in Selective Contracting
255
12
Contract Law Issues
257
2
Antitrust Law Issues
259
1
Any Willing Provider Laws
260
7
Financial Incentives to Provide Less Care
267
14
Types of Financial Incentives to Provide Less Care
269
2
Legal Implications of Financial Incentives to Provide Less Care
271
10
Controlling Utilization of Healthcare Services
281
1
The Process of Prospective Utilization Review
282
1
Legal Liability for Improper Denial of Claims
283
2
What the Federal ERISA Law Currently Provides
285
5
Ways to Get Around the ERISA Law
290