Scenario 5 A member of the hospital\'s medical staff has been accused of imprope
ID: 123079 • Letter: S
Question
Scenario 5 A member of the hospital's medical staff has been accused of improperly billing Medicare for treatments done in his office that were not medically necessary. A subpoena for copies of patient records was received, but the subpoena does not include a patient authorization for release of records. In addition, the subpoena requests all "peer review committee" records pertaining to this physician. Consider the following questions: 1. What must you check before releasing the patient records? 2. What legal concept described in this chapter will determine admissibility of the hospital records into evidence? 3. The defendant's lawyer objects to the subpoena, arguing that the patient records are "hearsay". To resolve this issue, identify at least one element will likely be required in your testimony. 4. Your hospital attorney objects to the subpoena of the peer review committee materials, citing state law that protects peer review records from discovery. What legal concept describes this protection? 5. While acting on the subpoena, you discover that one of the patient records (which are electronic) has had major sections deleted. Your review of the audit trails determines that a hospital staff member was responsible for the deletions. Under what legal concept could the hospital be subject to liability for the deletions? What should have been done to protect the records?Explanation / Answer
(1) If the patient is 18 years or older, the patient must sign / permit the release unless:
-the patient is unskilled,
-the patient is incapacitated and cannot sign the form by self, OR
-the patient is departed. (The living spouse or lawful representative with permissible proof must sign the approval for announcement of the deceased patient’s archives.)
If the patient is 18 years or younger, the patient must sign the release if:
-the patient is 14+ years or grownup and the archives include treatment for mental sickness, liquor or drug misuse/management, domestic/sexual attack, or AIDS examination OR
-the patient’s archives for announcement comprise an abortion process.
(2) Despite the fact that the record is released and considered to be a public document, all of it is not unavoidably admissible. Subsequent to this notion, hospital records have been self-confessed to prove that the patient’s consent not being part of the release shows negligence on their part.
(3)The one point needed is – patient’s authorization not included.
(4)Peer review confidentiality: The applied result of these provisions is that, in the occasion a court happening rises over the medicinal care deliberated at a board meeting, none of the info or annals of the conference can be subpoenaed, and not one of the members in the minutes can be bound to reveal any of the substances conversed, any of the censures of the maintenance that may have remained pronounced, or any assumptions grasped by the assembly.
(5)This is violation of HIPAA, and the staff who is proved to be responsible for it would be facing charges pressed against him / her. The records should not have restricted access to medical staff who actually require to review It for medicinal / treatment purposes.
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