Keeping Secrets: Confidentiality, Disclosure and the Duty to Report

Course Description

How far will you go to protect yourself, your colleagues, your patients? Is confession really good for the soul? This 4 hour course will explore the difficult issues that arise when you become aware of indiscretions of others, and your professional responsibilities and integrity come into conflict with your loyalties. Federal laws and regulations outlining our duty to report will be presented, followed by group discussions of the related ethical concepts of honesty, loyalty, autonomy, and informed consent, and how they may create conflicts for us in our clinical practice as well as our daily lives. This presentation meets the 4 hour licensure requirement for Ethics and Jurisprudence.

Course Objectives

Upon successful completion of this seminar, the participant will be able to:

  • Have a basic understanding of Qui Tam actions, the False Claims Act, Anti-kickback and Stark Laws
  • Identify organizational and practitioner behavior that would violate State and Federal False Claims Acts, including actions that you may unknowingly be doing
  • Understand the trend of government enforcement relating to health care claims
  • Identify our legal duties related to maintaining confidentiality vs. disclosure and reporting
  • Relate our ethical responsibilities of veracity and fidelity to respecting autonomy through confidentiality
  • Recognize the conflict in divided loyalties inherent in a duty to report
  • Explore the differences between various methods of keeping or providing information
  • Apply the concepts presented in this course to case discussions and conflicts in one’s own practice

Continuing Education Credit

4 CEU hours for Ethics and Jurisprudence awarded by Marquette University as per WI State Statue 9.04(1) as an approved organization - courses previously approved for E&J by the WPTA. A certificate of attendance will be provided to each participant after verification of successful completion of quiz.

Presenters

Adella DeaconAdella Deacon, PT, MPT, JD received her Bachelor of Science degree in Exercise Science from Marquette University in 2003. She received her Doctor of Physical Therapy degree in 2005, also from Marquette University. Dr. Deacon went on to earn her law degree from Chicago-Kent University and graduated with her Juris Doctor in 2011. She is admitted to the Illinois Bar. While pursuing her law degree Dr. Deacon has had experience with health and disability, immigration, construction, labor, property and contract law. Her clinical experience has primarily focused in outpatient orthopedics where she has worked with a variety of populations. She specializes in sports rehab of high school to professional athletes. She has also practiced in inpatient acute and inpatient rehab settings.

Tina StoeckmannTina Stoeckmann, PT, DSc, MA is a Clinical Associate Professor in the Department of Physical Therapy at Marquette University. She has served on the WPTA Ethics Committee since 2000 including several years as Chair. She has also been a member of the Southeast Wisconsin Developmental Disability Ethics Committee. She received her Bachelor of Science degree in Physical Therapy from the UW – Madison in 1988, a Masters of Arts in Bioethics from the Medical College of Wisconsin in 1999, and her DSc in Neurology from Rocky Mountain University of Health Professions in 2008. Her clinical background has been primarily in neurologic rehabilitation, specializing in traumatic brain injury, and she continues to practice clinically at Froedtert Hospital on the Neurologic Rehab unit. Tina has presented to a variety of audiences at the high school, college, and professional levels on ethics topics including rehabilitation ethics, social justice, informed consent, balancing business and professional ethics, and professional boundaries, among others.

References

  • APTA Code of Ethics and Guide for Professional Conduct: www.apta.org
  • Allen AL. Confidentiality: an expectation in Health Care. Scholarship at Penn Law 2008; NELCO scholarship repository.
  • Dougherty CJ. “Whistleblowing in health care” in Encyclopedia of Bioethics, Vol. 5. 2008; Simon & Schuster MacMillan, New York, NY. 1995.
  • Dunn D. Do no harm: our duty to report. Nursing Management 2010 (June):38-43.
  • Hall JK. Legal consequences of the moral duty to report errors. JONA’s Healthcare Law, Ethics, and Regulation 2003;5(3):60-4.
  • Monson MS. What to know about duty to report. Nursing Management 2005 (May):14-6,65.
  • Purtilo RB. Beyond disclosure: seeking forgiveness. Phys Ther 2005;85(11):1124-6.
  • Winslade W. “Confidentiality” in Encyclopedia of Bioethics, Vol. 1. Simon & Schuster MacMillan, New York, NY. 1995.
  • Robert T. Rhoad, Esq., 19 No. 5 Health Law. 18, “False Claims Act Education Requirements Under The Deficit Reduction Act: Compliance Guidance For Health Care Organizations In The Wake of Uncertainty,” April 2007.
  • Robert Salcido, 13 No. 5 Health Law. 1, “The Government Unleashes The Stark Law to Enforce The False Claims Act: The Implications of The Government’s Theory For The Future of False Claims Act Enforcement,” August 2001.
  • Jim Walden, Practicing Law Institute: “2010 Mid-Year False Claims Act Update,” November 2010
  • Joel M. Androphy, Houston Lawyer, “Federal Qui Tam Litigation: The Government’s Watchdog,” January/February 2005
  • Ebeid ex rel United States of America v. Lungwitz, 616 F. 3d 993 (9th Cir. 2010)
  • United States of America ex rel Hampton v. Columbia/HCA Healthcare Corp, 318 F. 3d 214 (D.D.Cir 2003).
  • Bryce L. Friedman, Practising Law Institute: “Overview of the Federal False Claims Act for Municipal Lawyers,” July 2011
  • Michael A. DiSabatino, 35 A.L.R. Fed 805, “Measure and Elements of Damaged under False Claims Act,”
  • Patrick A. Scheiderer, 33 INLR 1077, “Medical Malpractice as a Basis for a False Claims Action,”
  • Joan H. Krause, 23 CDZLR 1363, “Promises to Keep: Health Care Providers and the Civil False Claims Act” March 2002.
  • United States of America ex rel Lisitza v. Johnson & Johnson, 765 F. Supp 2d 112 (Dist Ct of Mass 2011)
  • Advance for Physical Therapy and Rehab Medicine: http://physical-therapy.advanceweb.com/News/Daily-News-Watch/Detroit-OT-Pleads-Guilty-of-Medicare-Fraud.aspx
  • CBS News: $4 Billion of Medicare Fraud Recovered in 2010
  • The Wall Street Journal: http://online.wsj.com/article/SB10001424052748704657704576150293189313156.html