Criminal Aspects of Health Care
Criminal Aspects of Health Care
© 2014 Jones and Bartlett Publishers
Chapter 5
Criminal Aspects of Health Care
© 2014 Jones and Bartlett Publishers
LEARNING OBJECTIVES
- Explain what criminal law is, the classification of crimes, and its purpose.
- Describe the criminal procedure process from arrest through trial.
- Describe several of the more common crimes that occur in the healthcare setting.
© 2014 Jones and Bartlett Publishers
Criminal law
- Criminal law (also known as penal law) is the body of statutory and common law that deals with crime and the legal punishment of criminal offenses.
- What is the purpose of criminal law?
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Purpose of Criminal Law
- Maintain Public Order & Safety
- Protect Individuals
- Use Punishment as a Deterrent
- Provide for Criminal Rehabilitation
- What are the definitions of a crime, misdemeanor & felony?
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Definitions
- Crime – social harm defined & made punishable by law.
- Misdemeanor – offense punishable by less than 1 year in jail and/or a fine.
- Felony – imprisonment in a state or federal prison for more than a year.
- What is an arraignment?
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Arraignment
- Formal reading of the accusatory instrument
- a generic term that describes a variety of documents, each of which accuses a defendant of an offense
- includes the setting of bail
- What is the purpose of a conference with the defendant and prosecutor?
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Conference
- Meeting for purposes of deliberation
- Plea bargaining time
- Commences with the goal of an agreed-upon disposition
- If no disposition can be reached, a case may be assigned to a trial court.
- Describe the process of conducting a criminal trial.
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Criminal Trial – I
- Jury selection
- Opening statements
- Presentation of witnesses & evidence
- Standard of proof must be beyond a reasonable doubt.
- Summations
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Criminal Trial – II
- Instructions to the jury by the judge
- Jury deliberations
- Verdict
- must be unanimous
- Opportunity for appeal
- What does the False Claims Act of 1986 prohibit?
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False Claims Act of 1986
- Knowingly presenting a false claim for payment.
- making a false record to get a false claim paid.
- conspiring to defraud the government.
- making a false record to avoid an obligation to pay or transmit property to the government.
© 2014 Jones and Bartlett Publishers
Ethics in Patient Referral Act
- Prohibits physicians who have ownership interest or compensation arrangements with a clinical laboratory from referring Medicare patients to that laboratory.
- Requires Medicare providers to report the names & provider numbers of all physicians or their immediate relatives with ownership interests in a provider entity.
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