Revisit our Week One reading Courts 101: Understanding the Court System (pages 11-15). This week’s discussion will help you to place violations and penalties within a specific law and legal system. HCO and/or provider violations maybe both illegal and may result in financial penalties. Not all healthcare laws are enforced by the same entity. Some are enforced by the Office of Civil Rights. The Centers for Medicare and Medicaid, the State Professional Licensing Boards, Federal prosecutors. Some penalties are financial and others may result in losing a professional license or a facility registration. After violation providers and HCOs may be prohibited from participating in state or federal programs.
Format:
Find a current newspaper or scholarly article or an industry newsletter where a health care organization or a provider was found guilty of malpractice, criminal negligence, false credentials, failure to treat, or patient abandonment.
- Which critical health care error does the article address?
- Draw from your readings and experience to date. Assess what factors lead up to the error for both the HCO and the professional. Touch on Duties, Scope of Practice (state boards), and standard of care.
- Provide specific details of the case as to which law and whether it was tried in criminal or civil court.
- Sort out the legal system violation from the penalty. What penalties did occur and what penalties may have occurred but were not written in the article.
SOLUTION
One recent example of healthcare infractions concerns the Rio Hondo Community Mental Health Center in California, which was fined for breaking the HIPAA Right of Access law. The organization should have provided a patient with access to her medical data within the legally allowed 30 days, delaying access by more than 200 days despite many requests. The Office for Civil Rights (OCR) enforced the case and issued a civil monetary penalty of $100,000 (American College of Legal Medicine & American Board of Legal Medicine, 2024). This infraction occurred during the COVID-19 pandemic. However, the OCR stressed that pandemic conditions did not justify noncompliance with federal standards.
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