Critical regulatory issue in health care, a case of ambulatory surgical centers in America
According to (Lindsey Dunn, 2009) of Ambulatory Surgical Centers (ASCs), the nature of law issues facing surgical centers in America evolves around out patient and non members , doctors ownership of the centers and issues regarding the qualification of and safety of the nurses required. Robert Mosher explains this further by noting that the doctors’ ownership of the surgical centers poses a major issue in eradicating the retirees and ushering in new board members as major retirees are the owners of these centers. Associated with this is the problem of interpreting what the law requires in terms of coming with the acceptable market price in the buying and selling of the centers as away of changing ownership. Patients requiring surgical services are also hit by another problem of determining what goes to the doctors as a cover for their finances for the services offered. The rules have the advantage of stipulating the rights and the directions for the services, and the doctor’s monetary interests in the whole gamut of treatment process.
As put forward by (People to people Health Foundation, 2010) It is a requirement that should be put in writing by the surgery centers to inform the patients of any monetary interests by the doctors as a result of using the centre a few days before the patients goes in for the surgery, the contrary is that adhering to these rules has posed a problem. Amber MC and Graw Walsh, 2008 explains that among the nurse requirements on the other hand, is a prerequisite that all ASCs makes sure that all doctor ownership is a third of all the revenues generated by both surgeries done in the specified ASCs as well as those performed outside the said centers which is attributed to fair distribution of wages to both the doctors and other ASCs officers. In determining members fees the surgical centers are faced with another problem in the law about the interpretation of what is to be contained and exempted from the fees. Walsh further argues that Surgical centers from surgery procedures in most cases get so much revenue coming from people known to their previous clients and with it comes more monies from insurance firms who lack the knowledge of the best fair rates even though the patients suffer from higher monetary obligations in the long run, which in the end results to exploitation of the patient by the centers and the insurance firms. Some ASCs on the other hand ignores the collection of their fees from the client know patients as well as from the insurance firms as a result of being paid huge sums even without the said fee.
Laws on issues of surgical centers as noted by Wachler & Associates, healthcare attorneys in America for many years have not been fully dealt with, especially laws relating to out of the members fees, doctors’ ownership as well as the issue of safe nurse requirements which have not been covered well as per the expectation. This has therefore resulted into the following; ASCs in most case lack the know how to understand the agreements put forth in regard with what the fair value is in the market so as facilitate the selling and buying of the members ownership which is usually brought about by market uncertainty .As a result, it is a necessity for ASCs to agree that selling and buying of new stocks should be practiced from day to day and not wait until things are not going right in the market in order to facilitate the sales or equally not whenever the market is doing pretty well. It is also important for ASCs to have a list of all the doctors’ owners and make sure the copies of this is easily accessible to all the representatives of patients and the patients themselves as a way to promote accountability. They should also as matter of fact ensure that the list can be understood by all the stakeholders that may need to understand it. ASCs also should make sure that they adhere to all safe nurse requirements in order to avoid legal cases that could be brought forward against them and to ensure equitability and availability of funds. The idea that centers lack ways to enable them to know to what extent to waiver the doctors’ owners and what guidelines to follow in order to be consistent in their application as well as lacking the direction on what their patient clientele is billed is seen as a legal issue facing ASCs.
INCLUDEPICTURE “http://www.turnitin.com/images/spacer.gif” * MERGEFORMATINET INCLUDEPICTURE “http://www.turnitin.com/images/spacer.gif” * MERGEFORMATINET Functions of law on issues relating to surgical centers as supported by (H. J. Peter & S.M William, 2003) include the following; Firstly, it facilitates the coming up with regulations that will guide ASCs on how to come up with the best market rate INCLUDEPICTURE “http://www.turnitin.com/images/spacer.gif” * MERGEFORMATINET thus providing a mutual satisfaction to all the stakeholders in healthcare surgical centers. Secondly, the law enables the establishment of what guidelines to follow in order to be consistent in their application in terms of waiver values, come up with laws governing the adherence to safe harbor requirements therefore making centers to comply with the requirements, make sure they do not face bribery violation or anything coming with such vice. This will help surgical centers in the world and mostly in America to come up with the rules that should be followed when it comes to exemptions. It will also help in solving the problems of misunderstanding and lastly it assists ASCs to analyze state law on issues such as what the what fair competition, anti bribery, claims that should not be paid involves and ways on how to go about any of the problems arising from the issues above.
In recommending for effective functioning of the surgical centers, the law regarding all their health operations should be clearly defined and adhered to with proper mechanisms put in place by the judicial system and all stakeholders involved in provision of healthcare to ensure that they are applied effectively and to the later
Lindsey Dunn, 2009: ASCREVIEW: Practical Business, Legal and Clinical Guidance for Ambulatory Surgical Centers as extracted from HYPERLINK “http://www.beckersasc.com/news-analysis-asc/antikickback-legal-regulatory/top-lawyers-discuss-current-critical-legal-issues-facing-surgery-centers.html” http://www.beckersasc.com/news-analysis-asc/antikickback-legal-regulatory/top-lawyers-discuss-current-critical-legal-issues-facing-surgery-centers.html as it appeared on 7 May 2010.
Sage and Hammer, “A Copernican View of Health Care Antitrust”; and W.M.Sage, D.A. Hyman, and W. Greenberg, “Why Competition Law Matters to Health Care Quality,” HealthAffairs (Mar/Apr 2003): 31–44.
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