PSYC324 Psychology Of Addiction And Substance Abuse

Question: This week provides an introduction to the legal foundations of the health care industry. As a health care administrator, you must have a working knowledge of the many legal issues involved in the industry, including the payment system, the frauds visited on that system, and the interplay of criminal prosecutions with government regulations. You also must understand the dynamics of relationships among providers and between providers and payers, as well as the burgeoning area of corporate compliance programs. Strong leadership and management skills, along with knowledge of the legal framework for health care fraud enforcement, are essential for health care administrators to be effective in their role. This week, you will explore federal and state laws imposing criminal and civil penalties on health care providers for a variety of fraudulent activities. You will examine laws related to the regulation of medical services, medical professionals, and standards of care; medical malpractice and liability; and access to health care, including institutional liability. You also will review the role of government and law in promoting and protecting health, such as the functions of courts, legislatures, and administrative agencies. You will discuss a recent criminal case involving a health care facility and identify the specific laws involved as well as the ramifications of this criminal act on the individuals and organizations involved. Finally, you will choose a topic for your Final Project. Learning Objectives Students will: Evaluate criminal laws related to health care administration Analyze ways health care administrators could prevent and address criminal acts Analyze motivations behind criminal acts Analyze legal and ethical policy issues in health care administration Answer: Brief Description Of The Case The case at hand focuses on the issue of introduction of adulterated drugs into the consumer market as well as the interstate commerce sector. AmerisourceBergen Corporation- ABC was involved in the adulteration of drugs and as a result, it pleaded guilty to the accusations. The company agreed to settle the dispute. In this case, the National Association of Medical Fraud Control Units made an announcement on 1st October 2018 that an agreement was reached between the federal government, 43 other states, and ABC to clear the allegations. In the settlement, ABC agreed to pay $625 million dollars to the federal government. Also, $99,863,569 of the fines was to be awarded to different Medicaid programs. In addition, AmerisourceBergen Specialty Group which is a subsidiary group of ABC pled guilty for having distributed misbranded drugs illegally in 2017. Apart from this, the company paid forfeitures and criminal fines worth $260 million, (Laing, Tupper, and Fairbairn, 2018, 60). The facts of this case involve Medical Initiatives Inc. – MII which is a pharmacy owned by ABSG in Dothan. The pharmacy sold pre-filled syringes to practitioners. Investigations revealed that the pharmacy tampered with the drug seals approved by the Food and Drug Authority, and repackaged them further into syringes hence allowing them to sell the overfill. Regarding this case, one possible factor that may have caused the perpetrators to act this way is the high demand for drugs in the market. The demand for illegal and adulterated drugs is also driven by the high price paid by patients and as such, it is a lucrative business, (Tupper, 2018, 243). Evaluation Of The State Or Federal Laws Covering The Case The Federal Food, Drug, and Cosmetic Act is at the forefront in setting regulations and prohibiting the distribution of drugs and cosmetics that may have been adulterer or may have been misbranded especially in interstate commerce- FD&C Act, sec. 301(a); 21 U.S.C. 331(a) 2015. The Act also emphasizes acts such as mutilation, alteration, obliteration, destriuction, and removal of part or whole labeling in relation to food, drugs, cosmetics or devices. These regulations also cover the commerce between states or territories as stipulated by Section 201(b) FD&C Act [21 U.S.C. 321(b), (US Food and Drug Administration, 2015). Ramifications Of The Criminal Action For Individuals And Organizations Involved The main ramifications include the payment of huge fines as exhibited in this case. Also, the company gets negative reputations. In most cases, individuals found guilty of these crimes face jail terms and lost their jobs in the long run, (Aliferov, 2018, 17). What Could An Administrator Do To Prevent This From Happening Or To Address It Effectively Once It Is Detected? Administrators have the duty of establishing stringent rules and regulation in the company. Performing internal audits is also essential so that it is determined whether the employees or the company complied with federal regulations or not. This was done by the Chief Financial Officer- Tim G Guttman in 2017. Adulteration at times happens because of corruption by some employees and the best way is to monitor their operations apart from setting regulations and agreements which make them squarely liable for their crimes, (National Academies of Sciences, Engineering, and Medicine, 2018, 350). With the use of technology, drugs can have digital seals which alert the end recipient when seals are being tampered with. Most importantly, employees and other parties should be educated in the ramifications illegal acts may cause including loss of employment, heavy fines, and jail terms and also the consequences that consumers may face after consuming the adulterated drugs. References: Aliferov, E. (2018). The Role of Direct Injury Government Entity Lawsuits in the Opioid Litigation. Routledge. 2(1), 17. https://ir.lawnet.fordham.edu/cgi/viewcontent.cgi?article=5570&context=flr Laing, M. K., Tupper, K. W., & Fairbairn, N. (2018). Drug checking as a potential strategic overdose response in the fentanyl era. International Journal of Drug Policy, 62, 59-66. https://www.ncbi.nlm.nih.gov/pubmed/30359874 National Academies of Sciences, Engineering, and Medicine. (2018). Impact of the Global Medical Supply Chain on SNS Operations and Communications: Proceedings of a Workshop. National Academies Press.23, 312-400 https://www.nap.edu/catalog/25149/impact-of-the-global-medical-supply-chain-on-sns-operations-and-communications Tupper, K. W., McCrae, K., Garber, I., Lysyshyn, M., & Wood, E. (2018). Initial results of a drug checking pilot program to detect fentanyl adulteration in a Canadian setting. Drug and alcohol dependence, 190, 242-245. https://www.ncbi.nlm.nih.gov/pubmed/30064061 US Food and Drug Administration. (2015). Federal Food, Drug, and Cosmetic Act (FD&C Act). 2014-02-20]. https://www.fda.gov/ICECI/CriminalInvestigations/ucm577788.htm U.S. Department of Justice Press Release September 27, 2017: Amerisourcebergen Specialty Group Pleads Guilty to Distributing Misbranded Drugs and is Sentenced to Pay $260 Million to Resolve Criminal Liability. https://www.fda.gov/ICECI/CriminalInvestigations/ucm577788.htm Audit Report- https://investor.amerisourcebergen.com/static-files/fc6fce15-1eda-4ef3-94a8-72d64ffc0301

PSYC324 Psychology Of Addiction And Substance Abuse

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