SOLUTIONS MANUAL
Legal and Ethical Aspects of Health Information Management
5th Edition by Dana C. McWay
CONTENTS
CHAPTER 1 Workings of the American Legal System ............................................................................................ 1
CHAPTER 2 Court Systems and Legal Procedures.................................................................................................... 6
CHAPTER 3 Judicial Process of Health Information ............................................................................................... 10
CHAPTER 4 Principles of Liability.......................................................................................................................... 14
CHAPTER 5 Ethical Standards................................................................................................................................. 18
CHAPTER 6 Ethical Decisions and Challenges ....................................................................................................... 21
CHAPTER 7 Bioethical Issues ................................................................................................................................. 26
CHAPTER 8 Patient Record Requirements .............................................................................................................. 29
CHAPTER 9 Confidentiality and Informed Consent ................................................................................................ 35
CHAPTER 10 Access to Health Information ............................................................................................................. 39
CHAPTER 11 Specialized Patient Records ................................................................................................................ 44
CHAPTER 12 Risk Management, Quality Management, and Utilization Management ............................................ 50
CHAPTER 13 Information Systems ........................................................................................................................... 55
CHAPTER 14 Health Care Fraud and Abuse ............................................................................................................. 60
CHAPTER 15 Law and Ethics in the Workplace ....................................................................................................... 64
APPENDIX A Legal Scenarios ................................................................................................................................... 67
APPENDIX B Ethical Scenarios ................................................................................................................................. 69
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, CHAPTER 1
Workings of the American Legal System
Chapter Summary
As health care becomes more complex, the interplay between the law and health care increases. Government regulation of the health care
field continues almost without pause, while lawsuits against health care providers appear to increase. The interplay of these forces
significantly affects the ability to manage patient-specific health information. Thus, those who are concerned with protecting health
information must possess a fundamental understanding of the law. This chapter provides that understanding through a discussion of the
differences between public law and private law, the sources of law, the branches of government and their respective roles, and quasi-legal
requirements to which health care organizations are subject.
Curriculum Crosswalk
HIA program
Domain: Health Law & Compliance
Competency: Comply with legal processes impacting health information
Curricular guidance: • Healthcare legal terminology
• Public law; private law; civil law; criminal law; torts and consent
• HIPAA, The Joint Commission, state laws, federal laws
• U.S. legal system
o (courts, sources of law)
• Types of law
o (public/private)
Domain: Data Structure, Content, & Information Governance
Competency: Analyze strategies for the management of information
Curricular guidance: • Federal legislation
o (e.g., Health Insurance Portability and Accountability Act)
• Healthcare accreditation standards
o (e.g., American Osteopathic Association, The Joint Commission)
Competency: Evaluate policies and strategies to achieve data integrity
Curricular guidance: • Healthcare documentation standards: The Joint Commission,
American Osteopathic Association, Medicare Conditions for
Coverage, Medicare Conditions of Participation and state regulations
(e.g., state department of health documentation and licensure
regulations)
• Healthcare facility documentation policies: medical staff bylaws, rules,
and regulations; health information management department policies
and procedures
Domain: Information Protection: Access, Use, Disclosure, Privacy, & Security
Competency: Recommend privacy strategies for health information
Curricular guidance: • Privacy laws and regulations
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,2 Legal and Ethical Aspects of Health Information Management
HIT program
Domain: Health Law & Compliance
Competency: Apply legal processes impacting health information
Curricular guidance: • United States legal system
Competency: Demonstrate compliance with external forces
Curricular guidance: • Federal and state legislation
Competency: Identify the components of risk management related to health information
management
Curricular guidance: • Licensure, physician privileges
Domain: Information Protection: Access, Use, Disclosure, Privacy, & Security
Competency: Apply policies, regulations, and standards to the management of information
Curricular guidance: • Federal legislation
o (e.g., Health Insurance Portability and Accountability Act)
• Healthcare accreditation standards
o (e.g., American Osteopathic Association, The Joint Commission)
Domain: Data Structure, Content, & Information Governance
Competency: Describe health care organizations from the perspective of key stakeholders
Curricular guidance: Healthcare Delivery Forces
• External forces (e.g., accreditation agencies, federal regulatory
agencies, government programs and third-party payers, professional
associations)
Competency: Apply policies, regulations, and standards to the management of information
Curricular guidance: Policy Strategies
• Federal legislation (e.g., HIPAA)
• State legislation (e.g., licensure)
• Health care accreditation standards (e.g., the Joint Commission)
Teaching Exercises
1. Teach the students to access various sources of law using the Internet. Demonstrate in the classroom or through online discussion
how to access the two best websites for free legal research of federal laws: https://www.congress.gov and https://www.govinfo.gov.
The first website is maintained by the Library of Congress and contains bill summaries and tracking as well as public laws. The
second website is maintained by the Government Printing Office and allows access to official information from all three branches of
government, including enacted statutes, rules, the Code of Federal Regulations, and the Federal Register. You can select any of the
citations to federal statutes or regulations found in the text and the online companion to the text, or you may use any of the
following:
HIPAA 42 U.S.C. § 1320d 45 C.F.R Part 162 (Admin. Requirements)
45 C.F.R Part 164 (Privacy & Security)
GINA 42 U.S.C. § 2000ff
After demonstrating how to find these examples, task the students with exploring the websites themselves to locate federal statutes
and/or regulations that are of interest to them.
2. Discuss the elements of a contract, identified in Table 1.2 in the textbook. Note that the listing makes the assumption that the parties
to the contract are competent to act. Introduce to the class the idea that some parties may not be considered competent under the law,
using minors as the example. Explain that the law generally considers minors not to possess the full maturity of mind and judgment
that is assumed for adults. Excluding the instance of emancipated minors, ask the students to identify what advantages and
disadvantages exist for minors and those with whom they contract. Examples of advantages for the minor include:
• the ability of a minor to cancel (void) a contract that he or she entered into and now regrets;
• the ability to refuse to sign contracts/not be forced into contracts that the minor doesn’t wish to enter; and
• the ability to share responsibility for the obligations of contracts with an adult who serves as a co-signer.
, Chapter 1 Workings of the American Legal System 3
Examples of an advantage for those who contract with minors include:
• the ability to require an adult to act as a co-signer to a contract, potentially increasing the ability for the responsibilities of the
contract to be fulfilled.
Examples of disadvantages for the minor include:
• the inability to contract without the assistance of an adult; and
• the inability to hold the opposing side responsible to fulfill the terms of the contract entered into by the minor.
Examples of disadvantages for those who contract with minors include:
• the inability to hold the minor responsible to fulfill the terms of the contract entered into by the minor; and
• the risk that the minor may cancel the contract at any time, citing the status as a minor as the reason.
Suggested Enrichment Activity
1. Bloom’s Taxonomy level: Application and analysis
AHIMA-revised Bloom’s Taxonomy levels: Apply and analyze
Using Table 1.4, Words of Authority, as a guide, review the statutory provisions found in the online companion to the text, looking
for instances where these words of authority are employed. Determine the level of change that would occur to the meaning of the
statutory provision if one or more of the words of authority found in Table 1.4 were substituted for the word of authority currently
located in the statutory provision.
2. Bloom’s Taxonomy level: Application
AHIMA-revised Bloom’s Taxonomy level: Apply
The first teaching exercise introduced the students to the government website where they can find federal regulations easily,
https://www.govinfo.gov. Taking the exercise to the next level, ask the students to follow a regulation through the notice and
comment process. Using https://www.govinfo.gov, ask the students to click on the Federal Register and then choose between the
entries for the Food and Drug Administration, the Health and Human Services Department, or the National Institutes of Health (or
another federal agency of your choice). A series of notices will be displayed under these entries. Some notices will indicate material
that is submitted for public comment, while other notices may indicate final guidance. Ask the students to choose one of the notices
and provide you with a summary of the notice, including the following pieces of data:
• The title and date of the notice
• The comment period deadline
• What law the regulation supports/complies with
• A summary of what the regulation covers and purports to accomplish
• The estimate for overall cost (in dollars) for implementing the regulation (if listed)
A similar activity can be undertaken using the website of a respective state.
Critical Thinking
Differentiating between private and public law is not always easy. Would you agree that the following statements properly differentiate
between the two types of law?
1. Private law applies to issues that affect individuals and groups of people or organizations, whereas public law applies to issues that
affect society as a whole.
2. Private law applies to verbal contracts, whereas public law applies to written contracts.
3. Private law applies to criminal matters, whereas public law applies to governmental matters.
Things to Consider
Only the first statement listed is correct; the other two are incorrect. The first statement is correct because it basically restates the
definitions listed in the text. The second statement is incorrect because contracts are a matter of private law, regardless of whether the
contracts are verbal or written. The third statement is incorrect because criminal matters can only fall under public law, whereas
governmental matters could fall under either public or private law, depending on the circumstances of a given problem.
Critical Thinking
Rights and duties can vary based on the specific language of a statute, rule, or regulation. Consider the impact of changing the word must
to may in the following sentence:
A covered entity must train all members of its workforce on the policies and procedures with respect to protected health information.
