Students are to read the Case Study below from the text Today’s Health Information Management: An Integrated Approach, 2nd edition by Dana C. McWay in Chapter 4, Ethical Standards, on page 116 and answer the review questions below. Identify the ethical challenge and discuss how you would handle this situation. Include resources supporting your approach to a resolution.
CASE STUDY :
You are a health information manager in a financially troubled acute care hospital, responsible for coding functions. The hospital’s administration has retained an independent consultant who has promised to increase the hospital’s financial reimbursement under Medicare. The consultant recommends that your staff be more aggressive in applying diagnostic codes in order to elevate reimbursement. Furthermore, the consultant shares with you methods that can be used to avoid detection of the aggressive coding scheme. You believe this more aggressive approach is, at minimum, inappropriate—and at worst, illegal. You have further learned that the consultant’s fee is based in large measure on a percentage of the hospital’s increased reimbursement under Medicare. Identify the ethical challenge and discuss how you would handle this situation.
REVIEW QUESTIONS: 1. How can one distinguish between legal and ethical issues? 2. Compare the steps typically taken in the ethical decision-making process 3. Why should health care providers be aware of bioethical issues? 4. Name the three direct ethical roles that supervisors play in organizations. 5. What are the most frequent ethical challenges in health information management? 6. How can health information managers experience ethical challenges from third parties?