The jury determines the questions of law and the Judge determines the questions of fact.  

The attractive nuisance doctrine

Use the following information in questions 34 through 37 General Hospital and Magellan Insurance entered into a contract.  General Hospital agreed to provide healthcare services to Magellan’s insured lives.  General Hospital will be paid for inpatient services on a DRG-basis.  Outpatient services will be paid on a fee schedule basis. The contract includes a two-sided shared savings model, with quality indicators.  In the prior year, Magellan paid General Hospital $500 million for healthcare services.  This year, General Hospital and Magellan agreed to a target of $475 million.  General Hospital and Magellan agreed to the following: If actual costs are up to $5 million above or below the target, Magellan retains the cost savings/excess costs If actual costs are $5 million to $10 million above or below target, the savings/excess will be shared equally by General Hospital and Magellan. If actual costs are $10,000,001 to $25,000,000 above or below target, the savings/excess will be shared 75% (General Hospital)/25% (Magellan) Any cost savings/excess costs above $25,000,000 will be retained by Magellan Quality Indicators must be met to share in any cost-savings, and have no impact on shared losses. Indicate the shared savings/shared losses amounts General Hospital should record for each of the following scenarios.  Actual costs were $4 million over target and quality measures were better than goal?

Use the following information in questions 34 through 37 General Hospital and Magellan Insurance entered into a contract.  General Hospital agreed to provide healthcare services to Magellan’s insured lives.  General Hospital will be paid for inpatient services on a DRG-basis.  Outpatient services will be paid on a fee schedule basis. The contract includes a two-sided shared savings model, with quality indicators.  In the prior year, Magellan paid General Hospital $500 million for healthcare services.  This year, General Hospital and Magellan agreed to a target of $475 million.  General Hospital and Magellan agreed to the following: If actual costs are up to $5 million above or below the target, Magellan retains the cost savings/excess costs If actual costs are $5 million to $10 million above or below target, the savings/excess will be shared equally by General Hospital and Magellan. If actual costs are $10,000,001 to $25,000,000 above or below target, the savings/excess will be shared 75% (General Hospital)/25% (Magellan) Any cost savings/excess costs above $25,000,000 will be retained by Magellan Quality Indicators must be met to share in any cost-savings, and have no impact on shared losses. Indicate the shared savings/shared losses amounts General Hospital should record for each of the following scenarios.  Actual costs were $20 million under target, and quality measures were better than goal?

Use the following information in questions 34 through 37 General Hospital and Magellan Insurance entered into a contract.  General Hospital agreed to provide healthcare services to Magellan’s insured lives.  General Hospital will be paid for inpatient services on a DRG-basis.  Outpatient services will be paid on a fee schedule basis. The contract includes a two-sided shared savings model, with quality indicators.  In the prior year, Magellan paid General Hospital $500 million for healthcare services.  This year, General Hospital and Magellan agreed to a target of $475 million.  General Hospital and Magellan agreed to the following: If actual costs are up to $5 million above or below the target, Magellan retains the cost savings/excess costs If actual costs are $5 million to $10 million above or below target, the savings/excess will be shared equally by General Hospital and Magellan. If actual costs are $10,000,001 to $25,000,000 above or below target, the savings/excess will be shared 75% (General Hospital)/25% (Magellan) Any cost savings/excess costs above $25,000,000 will be retained by Magellan Quality Indicators must be met to share in any cost-savings, and have no impact on shared losses. Indicate the shared savings/shared losses amounts General Hospital should record for each of the following scenarios.  Actual costs were $12 million under target, and quality measures were worse than goal?

Use the following information for questions 29 through 32 Metropolitan Hospital signed a one-year contract with Sunshine Insurance Company.  Under the terms of the contract, Metropolitan Hospital will receive $80 per member per month (PMPM) from Sunshine for 100,000 people covered by Sunshine’s health insurance products.  In exchange for the payment, Metropolitan agrees to provide hospital inpatient and outpatient services to any assigned life who presents to Metropolitan. In the month of July, the following events occurred: On July 1, Metropolitan received its capitation payment for the month of July. During July, Metropolitan provided services to patients covered by its contract with Sunshine.  The billed charges totaled $15,000,000 and are automatically posted to Metropolitan’s general ledger.   In July, Metropolitan analyzed its performance under the Sunshine Insurance Company contract and determined it lost $1,200,000 on the contract in the first six months of the year (January through June).  Assume Metropolitan’s data analytics department determined the $1,200,000 loss was caused by unusually high patient admissions in the first quarter, coinciding with a serious flu epidemic.  The contract is expected to generate at least a $500,000 profit in the last six months of the contract.  What journal entry, if any, should Metropolitan record in July related to future losses under the contract?

Use the following information for questions 29 through 32 Metropolitan Hospital signed a one-year contract with Sunshine Insurance Company.  Under the terms of the contract, Metropolitan Hospital will receive $80 per member per month (PMPM) from Sunshine for 100,000 people covered by Sunshine’s health insurance products.  In exchange for the payment, Metropolitan agrees to provide hospital inpatient and outpatient services to any assigned life who presents to Metropolitan. In the month of July, the following events occurred: On July 1, Metropolitan received its capitation payment for the month of July. During July, Metropolitan provided services to patients covered by its contract with Sunshine.  The billed charges totaled $15,000,000 and are automatically posted to Metropolitan’s general ledger.  What revenue does Metropolitan record in its financial statements in July?

Damages refers to the plaintiff’s provable losses.

The plaintiff’s burden in proving his tort case is beyond a reasonable doubt.

When a plaintiff proves his tort case, he is entitled to request prison time for the defendant.