Guidelines:

I: Identify the Issue

R: Identify the Rule: ((e.g., negligence, battery, invasion of privacy, defamation, sexual harassment, breach of warranty, etc.). Please document the language of the rule(s) and its elements. Provide the citation from the source of the rule language. Make sure that none of the facts from the case are included in the rule language. If the rule has more than one element, make sure to include and define each of the elements. Failure to completely define the rule will result in significant deduction of points. A: Apply the rule to the fact pattern C: Conclude with a recommendation to the physician, dentist, or yourself. Make sure to include any case law in your analysis. Write out the holding of the case and then describe how it is similar and informs the recommendation that you are making. Failure to include discussion of the cases will result in significant deduction of points

Scenario # 2: Another friend is a dentist who has a large geriatric practice with nursing home patients throughout Chester County. The dentist typically visited the residents and conducted routine dental examinations in an office specifically set up by the nursing home. As part of the routine exam and without the request of an attending physician or because of any medical concern, the dentist would also conduct an oral cancer screening. The dentist would then bill Medicare for both the routine dental exam and the oral cancer screening. In his own mind, the dentist never knowingly presented a false claim to be reimbursed by Medicare. But, he also deliberately never researched any of the laws or regulations to determine if conducting the additional oral screening was within a routine exam description. He openly bragged to his colleagues at the latest dental conference in Las Vegas that he also did not care whether he was breaking any law because he had not been caught yet and the pay was generous from Medicare and TRICARE. He bragged that if he "didn't know it was wrong, it could not be breaking the law" and he was not going to take any additional measures to find out. You recently became aware of your friend's actions because your loved one is a resident at one of the homes where the dentist visits. What advice would you give to the dentist after reading Chapter 15 of Showalter and consulting the case United States v. Lorenzo.

Scenario # 8: In 2005, another physician friend, Jaime Lannister (twin brother to Cersei) who lives in Westeros, SC became one of the owners of a 50-bed physician specialty hospital that specializes in knee, hip, and shoulder replacement surgeries. He is a member of a group of physicians who own 100% of the hospital and perform all their replacement surgeries in the hospital. The group of physicians hires all the staff and has purchased all the equipment at fair market value. Your friend sees all his patients at a separate office and refers all patients that require replacement surgeries to the hospital that is owned by the physician group, of which he is a full member. What advice do you have for your physician friend after the Affordable Care Act went into effect in 2010?