The Law of Health Care Organization and Finance (American Casebook Series)

This book is designed for a specialized health law course focusing on the organization and finance of health care. The first section 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 considers in particular the 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, employment and labor law, tax exempt organization law, fraud and abuse issues, and antitrust law. The sixth edition has been completely updated, covering recent developments involving consumer-driven health care, ERISA, antitrust enforcement, labor law, and tax-exempt organization law.