Jessica L. Bailey-Wheaton serves as Senior Vice President and General Counsel of Health Capital Consultants (HCC). Her work focuses on the areas of Certificate of Need (CON) preparation and consulting, as well as project management and consulting services related to the impact of both federal and state regulations on health care transactions. In that role, she provides research services necessary to support certified opinions of value related to the fair market value and commercial reasonableness of transactions related to health care enterprises, assets, and services.

Additionally, Ms. Bailey-Wheaton heads HCC’s CON and regulatory consulting service line. In this role, she prepares CON applications, including providing services such as health planning; researching, developing, documenting, and reporting the market utilization demand and “need” for the proposed services in the subject market service area(s); researching and assisting legal counsel in meeting regulatory requirements relating to licensing and CON application development; and providing any requested support services required in litigation challenging rules or decisions promulgated by a state agency. She has also been engaged by both state government agencies and CON applicants to conduct an independent review of one or more CON applications and provide opinions on a variety of areas related to health care planning. She has been certified as an expert in health care planning in the state of Alabama.

Contents

About the Authors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  v

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv

1. Health Care Organizational and Operational Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1

Catherine Greaves, Samantha Johnson, and Jacob Simpson

2. Physician Legal Issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 51

Mehrnaz M. Hadian, Luke P. Ihnen, Conrad Meyer, and Patrick D. Souter

3. Patient Care Issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 101

Denise Winiarski

4. Complaints, Claims, and Litigation. . . . . . . . . . . . . . . . . 141

Richard Lovich

5. Health Care Financing and Payors . . . . . . . . . . . . . . . . 173

Christian Puff and Jessica L. Gustafson

6. Fraud and Abuse Laws. . . . . . . . . . . . . . . .  . 207

Patti T. Cotten, Jessica Jernigan Johnson, Daniel T. Swanson, and Erin B. Williams

7. Telehealth . . . . . . . . . . . . . . . . 261

Elizabeth N. Pitman

8. Other Health Law Considerations . . . . . . . . . . . . . . . .. 285

Samantha Johnson, Emily Klatt, Joe Miller, Evelyn French, and Jessica Bailey-Wheaton

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363