course material

1. [From 10$/Pg] Thus Possibly Avoiding Legal
[From 10$/Pg] Thus Possibly Avoiding Legal How do they affect one’s character? How are
they acquired? How can they be helpful in resolving health care ethical dilemmas? (content
criteria #2)Identify and discuss a health-related case in which virtues and values played a
part. Discuss application/and interpretation of these virtues and values in your selected
case. (content criteria #3)Make sure you have an Introduction and Conclusion (content
criteria #1). A synopsis of United States Code, Federal Register, Code of Federal Regulations,
and state regulations that are applicable to patients, providers, third-party payers, and
administrators involved in health care industry.The United States CodeAs stated by the GPO
(2008), “the United States Code is the codification by subject matter of the general and
permanent laws of the United States. It is divided by broad subjects into 50 titles and
published by the Office of the Law Revision Counsel of the U.S. House of Representatives.
Since 1926, the United States Code has been published every six years. In between editions,
annual cumulative supplements are published in order to present the most current
information” (p.2). The relevance of the United States Code for patients, provides, third-
party payers, and administrators centers on applicable rights regarding access to health
care, laws governing pre-existing conditions, and liabilities. A prime example would be title
42, public health and welfare act, Chapter 7 health insurance for aged and disabled. The GPO
cites (2008), “an organization which provides medical and other health services (or
arranges for their availability) on a prepayment basis (and either is sponsored by a union or
employer, or does not provide, or arrange for the provision of, any inpatient hospital
services) may elect to be paid 80 percent of the reasonable cost of services for which
payment may be made under this part on behalf of individuals enrolled in such organization
in lieu of 80 percent of the reasonable charges for such services if the organization
undertakes to charge such individuals no more than 20 percent of such reasonable cost”
(p.4). Medicare and Medicaid regulations are very stringent and fall under proper coding via
the MDS coordinator (Minimum Data Set) for Long-Term care facilities. This to insure that
proper billing is applied to each patient receiving skilled care and long term care, thus
reducing the possibility of fraudulent billing practices.Federal RegisterAs stated by the
United States Department of Education (2008), “the Federal Register is the official daily
publication for rules, proposed rules, and notices of Federal agencies and organizations, as
well as executive orders and other presidential documents” (p.1). Thus applicable and
pertinent rulings are maintained according to subheadings and deemed public notices,
rules, and proposed rulings. A specific and primary example centers on HIPPA rules and

2. implementations within health care settings: The GPO states (2008), “The Department of
Justice (Department) is issuing this notice of proposed rulemaking (NPRM) in order to:
Adopt enforceable accessibility standards under the Americans with Disabilities Act of 1990
(ADA) that are “consistent with the minimum guidelines and requirements issued by the
Architectural and Transportation Barriers Compliance Board” (Access Board); and perform
periodic reviews of any rule judged to have a significant economic impact on a substantial
number of small entities, and a regulatory assessment of the costs and benefits of any
significant regulatory action as required by the Regulatory Flexibility Act, as amended by
the Small Business Regulatory Enforcement Fairness Act of 1996 (SBREFA)” (p.1). This
information would benefit patients regarding their rights to privacy and it would also
benefit providers, third-party payers, and administrators regarding proper compliance with
the individual HIPAA requirements, thus possibly avoiding legal liability ramifications.Code
of Federal RegulationsThe Library of Congress cites (2008), “the Code of Federal
Regulations (CFR) is the codification of the general and permanent rules published in the
Federal Register by the executive departments and agencies of the Federal Government. It is
divided into 50 titles that represent broad areas subject to Federal regulation. Each volume
of the CFR is updated once each calendar year and is issued on a quarterly basis” (p.1). The
federal regulations range from general provisions, to federal elections, banking, and labor
laws. However, an applicable regulation regarding health care corresponds to title 42 public
health, primarily pertaining to three aspects: public health service, centers for Medicare and
Medicaid services, and office of inspector general-health care, department of health and
human services. The code of federal rules is maintained and adherence is maintained
through federal and state regulations. Interestingly, the general public has a right to
participate and amend specific rulings. The Federal Register cites (2007), “citizens have a
right to express their views before an agency adopts final rules; furthermore, citizens have
the right to voice concerns applicable in accordance to federal rules” (p.2). The relevance of
this for patients centers on participation in their own positive health care outcomes. For
providers and administrators, proper compliance regarding federal rulings can be
maintained and established via ongoing education.State of Tennessee, Department of Health
and Human Services:The Tennessee Department of Health and Human Services (TDHS) is
set up to accommodate variants of care for the citizens of Tennessee. Thus they provide
services ranging from adult protection, child protection, food stamps, and Medicaid.
According to the Tennessee DHS office (2007), “the Department of Human Services
employees receive statewide training on Title VI compliance each year. As a result of this
training, everyone has been made aware that Title VI prohibits discrimination on the basis
of race, color, or national origin in any program or activity that receives federal funds or
other federal financial assistance. In order to ensure compliance with all aspects of Title VI,
the department must take steps to make certain that our growing ethnically diverse
population is served equitably and that they have meaningful access to all programs” (p.1).
This is an important aspect in the sense of compliance and funding, without proper
compliance, patients, providers, and administrators run the risk of decreased funding and
coverage for specific disease progressions.ReferencesGovernment Printing Office (2008).
The United States Code: Main page (Links to an external site.). Retrieved September 1, 2015

3. from http://www.gpo.gov/Tennessee Department of Human Services (2007). Guidance for
family assistance staff: citizenship, immigration status, and social security numbers. (Links
to an external site.) Retrieved September 1, 2015 from
http://www.tennessee.gov/humanservicesThe Federal Register (2007). The Federal
Register: what it is and how to use it (Links to an external site.). Retrieved June 2, 2015
from http://www.archives.gov/federal-register/tutorial/online-html.html#publicThe
Library of Congress (2008). The legislative process (Links to an external site.). Retrieved
June 2, 2015 http://thomas.loc.gov/.United States Department of Education (2008).
Federal register documents — U.S. Department of Education (Links to an external site.).
Retrieved June 2, 2105 from http://www.ed.gov/news/fedregister/index.html