ÌìÃÀ´«Ã½

Course Description

This course provides a framework for analysis of legal and ethical issues in the provision of healthcare. This course is an overview of health law issues and includes the conceptual foundations for societal, institutional, and individual dilemmas in healthcare delivery and the legal aspects of clinical and financial decision-making. It covers government regulation including legal constraints, liability, negligence, patient rights, confidentiality, as well as, corporate and administrative responsibility. (3 credits)

Associated Program Learning Outcome(s)

#3 Explain the role of the administrator in upholding the legal, social, and ethical responsibilities in the healthcare organization as they relate to patient/client rights

Student Learning Outcomes (SLOs)

Students who successfully complete this course will be able to:

1. Evaluate compliance program effectiveness by identifying key organizational attributes, developing a structured discovery process, and applying interviewing techniques in order to form an evidence‑based assessment of an organization’s compliance efforts. 
2. Analyze the elements of the False Claims Act, Anti‑Kickback Statute, and Stark Law and explain how these federal requirements apply to healthcare industry operations.
3. Evaluate conflicting regulatory guidance (Coding Clinic vs. MAC/LCDs) and apply primary and secondary sources of law to determine correct coding and compliance actions, including how to investigate, audit, and resolve potential non‑compliance in alignment with federal reimbursement rules. 
4. Accurately analyze EMTALA requirements and evaluate potential violations by applying federal regulations, case-based reasoning, and investigative methods to real‑world emergency care scenarios.
5. Apply core healthcare compliance principles by demonstrating ethical employee responsibilities and designing a comprehensive baseline audit program that incorporates regulatory expectations, audit methodology, and professional grade documentation.
6. Interpret and differentiate federal fraud and abuse laws, including the False Claims Act and Self‑Referral (Stark) Laws.
7. Perform an in-depth interpretation of the seven elements of a compliance program and the role of the OIG.
8. Apply HIPAA/HITECH privacy and security requirements to organizational workflows, including modern digital environments such as AI, tracking technologies, and ransomware preparedness.
9. Evaluate HIPAA/HITECH compliance risks and federal enforcement trends—including Right of Access, tracking technologies, business associates, PHI protection, emergency disclosures, and vendor oversight—to strengthen organizational risk‑management practices.
10. Evaluate whether a healthcare organization is subject to the Red Flags Rule, analyze identity‑theft threats and their operational impact, and develop core components of an Identity Theft Prevention Program that aligns with federal compliance expectations.

Course Activities and Grading

Required Textbooks

• This course uses Open Educational Resources (OER). OER are openly licensed, educational resources that can be used for teaching, learning and research. OER may consist of a variety of resources such as textbooks, videos and software that are no cost for students.

Additional Resources

• Office of Inspector General, U.S. Department of Health & Human Services. (2023). (HHS‑OIG Publication No. 1135). (Source: https://oig.hhs.gov/documents/compliance-guidance/1135/HHS-OIG-GCPG-2023.pdf)
• Brinson, S. G., Clack, L., Gill, L. M., & Gosa, L. K. (n.d.). . University of North Georgia Press. (Source: https://web.ung.edu/media/university-press/overview-of-healthcare-compliance.pdf?t=1661448716344)
• Journal Articles and other course material, including primary websites, will be provided as required reading within the course.

Course Schedule

COSC Accessibility Statement

ÌìÃÀ´«Ã½ encourages students with disabilities, including non-visible disabilities such as chronic diseases, learning disabilities, head injury, attention deficit/hyperactive disorder, or psychiatric disabilities, to discuss appropriate accommodations with the Office of Accessibility Services at OAS@charteroak.edu.

COSC Policies, Course Policies, Academic Support Services and Resources

Students are responsible for knowing all ÌìÃÀ´«Ã½ (COSC) institutional policies, course-specific policies, procedures, and available academic support services and resources. Please see COSC Policies for COSC institutional policies, and see also specific policies related to this course. See COSC Resources for information regarding available academic support services and resources.