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1430-59 Legal Principles of Health Information > Chapter 4 > Flashcards

Chapter 4 Flashcards

1
Q

executive orders

A

a rule or regulation issued by the president of the US that becomes law without the prior approval of congress

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2
Q

constitutional law*

A

law that derives from federal and state constitutions

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3
Q

case law*

A

law established through common law and legal precedent

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4
Q

common law

A

the body of unwritten law developed in England, primarily from judicial decisions based on custom and tradition

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5
Q

legal precedents

A

decisions made by judges in various courts that become rule of law and apply to future cases, even though they were not enacted by legislation

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6
Q

statutory law*

A

law passed by the US congress or state legislatures

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7
Q

administrative law*

A

including statues enacted to define powers and procedures when an agency is created

  • created by congress, by the president, or by individual state legislatures
  • regulations maybe passed that pertain specifically to the functions of one agency, such as the IRS, social security Administration or occupational safety and health administration

ex- health and human services

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8
Q

procedural law*

A

law that defines the rules used to enforce substantive law

ex- laws that require law enforcement officers to read suspects their rights (the Miranda warning) and govern the arrest and trial process and procedural laws

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9
Q

criminal law*

A

law that involves crimes against the state

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10
Q

felony*

A

an offense punishable by death or by imprisonment in a state or federal prison for more than one year

ex- abuse (child abuse, elder abuse, or domestic violence), arson burglary, conspiracy, embezzlement, fraud, illegal drug dealing, grand larceny, manslaughter, mayhem, murder or attempted murder, rape, robbery, tax evasion, and practicing medicine without a license

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11
Q

misdemeanors*

A

crime punishable by fine or by imprisonment in a facility other than a prison for less than one year

ex- some traffic violations, thefts under certain dollar amount, attempted burglary, and disturbing the peace

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12
Q

civil law*

A

law that involves wrongful acts against persons

people can sue another person, a business, or government

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13
Q

tort*

A

a civil wrong committed against a person or property, excluding breach of contract

must involve damage to property, or deprivation of civil liberties

may be intentional or unintentional

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14
Q

tortfeasor*

A

the person guilty of committing a tort

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15
Q

negligence*

A

an unintentional tort alleged when one may have performed or failed to perform an act that a reasonable person would or would not have done in similar circumstances

charged when a health care practitioner fails to exercised ordinary care and a patient is injured

can also be charged to an institution (what would or could a reasonable hospital do under similar circumstances?

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16
Q

jurisdiction*

A

the power of a court to hear and decide a case before it

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17
Q

plantiff*

A

the person bringing charges in the law suit

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18
Q

prosecution*

A

the government as plaintiff in a criminal case

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19
Q

defendant*

A

the person or party against whom criminal or civil charges are brought in a lawsuit

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20
Q

contract

A

a voluntary agreement between two parties in which specific promises are made for a consideration

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21
Q

void

A

without legal force or effect

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22
Q

breach of contract

A

failure of either party to comply with the terms of a legally valid contract

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23
Q

minor

A

anyone under the age of majority;18 years in most states, 21 years in some jurisdictions

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24
Q

statue of frauds

A

state legislation governing written contracts

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25
Q

List the 3 Branches of Congress

Federal Government

A

legislative
executive
judicial

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26
Q

Legislative Branch

Federal

A

made up of the two houses of CONGRESS:

  • the senate (6year terms)
  • the house of representatives (2 year terms)

-elected by people in his/her state

  • primary duties of congress include
    • making laws controlling trade between states and between the US and other countries
    • making laws about taxes and borrowing money
    • approving the printing of money
    • declaring war on other countries
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27
Q

Senate’s duties

Federal

A
  • approve and disapprove any treaties the president makes
  • approve or disapprove any people the president recommends for jobs, such as cabinet officers, supreme court justices and ambassadors
  • hold an impeachment trial for government official who commits a crime against the country
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28
Q

House of Representative duties

Federal

A
  • introduce legislation that compels people to pay taxes
  • decide if a government official should be put on trial before the senate if he or she commits a crime against the country (such a trail is called impeachment)
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29
Q

Executive Branch

Federal

A

the president

-executive orders become law without approval of congress

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30
Q

List 3 Purposes of Executive orders

Federal

A
  1. to create administrative agencies or change the practices of an existing agency
  2. to enforce laws passed by congress
  3. to make treaties with foreign powers
31
Q

List the 3 Branches of Congress

State Government

A

legislative
executive
judicial

32
Q

Legislative Branch

State

A

-those responsibilities not governed by the federal government are duties of the state

consists of two chambers;

  • senate(6 year terms)
  • house of representatives (assembly or general assembly) (2 year terms)
  • number of state legislators a state may elect is based on the number of political districts in each state because citizens elect legislators from the various districts. therefore, the number of members in state legislatures is not the same as the number of members in the US congress.
33
Q

Executive Branch

State

A

governor is the head of the state

  • each state has its own constitution, but state constitutions cannot conflict with the US constitution.
  • those responsibilities not delegated by the federal constitution are left to the state
34
Q

List the 4 types of law

A

1 constitutional law
2 case law
3 statutory law
4 administrative law

35
Q

Exclusive powers of the National Government

A
  • print money
  • regulate interstate (between states) and international trade
  • make treaties and conduct foreign policy
  • declare war
  • provide an army and navy
  • establish post offices
  • make laws necessary and proper to carry out the above powers
36
Q

Exclusive powers of the State Government

A
  • issue licenses
  • regulate intrastate (within the state) businesses
  • conduct elections
  • establish local governments
  • ratify amendments to the constitution
  • take measures for public health and safety
  • may exert powers the constitution does not delegate to the national government or prohibit the states from using
37
Q

Municipal ordinances

A

laws passed by city governments

38
Q

List 2 broad types of law

A

1 substantive law

2 procedural law

39
Q

substantive law*

A

the statutory or written law that defines and regulates legal rights and obligations// it defines the legal relationship between people or between people and the state and is further classified as;

criminal
civil
military
international law

ex - criminal laws that define murder, arson, and armed robbery as crimes and the civil laws that allow individuals to sure persons or entities

40
Q

assault

intentional tort

A

the open threat of bodily harm to another or acting in such a way as to put another in the “reasonable apprehension of bodily harm”

41
Q

battery

intentional tort

A

an action that causes bodily harm to another. it is broadly defined as any bodily contact made without permission

42
Q

trespass

intentional tort

A

wrongful injury to or interference with the property of another

43
Q

nuisance

intentional tort

A

anything that interferes with the enjoyment of life or property

44
Q

interference with contractual relations

intentional tort

A

intentionally causing one person not to enter into or to break a contract with another

45
Q

deceit

intentional tort

A

false statement or deceptive practice done with intent to injure another

46
Q

conversion

intentional tort

A

unauthorized taking or borrowing of personal property of another for the use of the taker

47
Q 
false imprisonment (false arrest)
(intentional tort)
A

unlawful restraint of a person, whether in prison or otherwise

48
Q

defamation

intentional tort

A

wrongful act of injuring another’s reputation by making false statements

49
Q

invasion of privacy

intentional tort

A

interference with a persons right to be left alone

50
Q

misuse of legal procedure

intentional tort

A

bringing legal action with malice and without probable cause

51
Q

infliction of emotional distress

intentional tort

A

intentionally or recklessly causing emotional or mental suffering to another

52
Q

fraud

intentional tort

A

dishonest or deceitful practices in depriving or attempting to deprive, another of his or her rights

53
Q

defamation of character

intentional tort

A

damaging a persons reputation by making public statements that are both false and malicious

54
Q

federal courts*

A

jurisdiction over federal laws

  • anti trust
  • fraud in medicare/medicaid
  • federal crimes
  • federal antitrust law
  • bankruptcy
  • patients
  • copyrights
  • trademarks
  • suits against the US
  • areas of admiralty law (pertaining to the sea)
55
Q

state courts*

A

each state is slightly different

structure includes local courts, trial courts, appellate courts and the state supreme court

56
Q

What are the four essential elements of a binding contract?**

A
  1. agreement
  2. condiseration
  3. legal subject matter
  4. contractual capacity
57
Q

expressed contracts**

A

written or oral agreements in which all terms are explicitly stated

58
Q

implied contracts**

A

unwritten or unspoken agreement whose terms result from the actions of the parties involved.

59
Q

What are grounds for Termination between the physician and patient?
( reasons why the physician can terminate)**

A
  • failure to pay for services
  • failure to keep appointments
  • failure to follow physicians instructions
  • patient seeks services of another physician
60
Q

Laws Governing Payment of Fees for Services**

A
  • third party payer contract
  • fair debt collection practices act
  • implied contracts
  • managed care plan contracts
61
Q

Rights of Physicians**

A
  • make reasonable limitations on physician-patient relationship
  • set up a practice based on credentials
  • set up an office and determine hours
  • specialize
  • decide what services will be provided and how they will be provided
62
Q

Patient Rights**

A
  • considerate and respectful care
  • information on diagnosis, treatment, and prognosis
  • information to give informed consent
  • refusal of treatment
  • confidentiality
  • continuity of care
  • knowledge of hospital rules
63
Q

office for civil rights

health and human services gov

A

upholds privacy laws

you can file a complaint with them if your privacy rights were violated

this is an example of federal laws that protect your confidentiality

64
Q

Implied duties of a patient

A
  • follow physician instructions and cooperate as well as able
  • give all relevant information to the physician to form diagnosis
  • follow physicians orders for treatment
  • pay fees for services rendered
65
Q

judicial

federal

A

SUPREME COURT

interprets and over sees laws

66
Q

judicial

state

A

the courts oversee state laws

67
Q

According to the AHRQ (Agency for Health Research and Quality), three types of patients are most likely to leave the hospital against doctors’ order. List them.

A
  1. Those who are worried about paying the medical bills
  2. Those with alcohol or substance abuse problems
  3. Those who have had a previous discharge against medical advice
68
Q

What percent of patients in hospitals are discharged against medical advice?

A

.8 percent to 2.2

69
Q

To protect against liability for any medical consequences resulting from early discharge. What must be done on the physicians behalf?

A

the patient’s insistence on leaving should be signed and filed with the patients medical record.

70
Q

National Practitioner Data Bank

A
  • The National Practitioner Data Bank (NPDB) was established through Title IV of Health Care Quality Improvement Act of 1986 (HCQIA).
  • It is a web- based repository of reports. This repository contains information on medical malpractice payments and certain adverse actions related to health care practitioners’ providers, and suppliers.
  • It is a tool that prevents practitioners from moving state to state without disclosure or discovery of pervious damaging performances.
  • Federal regulations authorize eligible entities to report to and or query the NPDB.
  • Individuals and organizations who are subjects of these reports have access to their own information. The reports are confidential, and not available to the public
  • Governed by two sections of the social security act. (1921 and 1128E)
71
Q

The Commission on Accreditation of Allied Health Education Programs

A

The CAAHEP oversees the accreditation process of a variety of individual allied health educational programs

  • There are 30 different allied health professions under the CAAHEP umbrella, examples including: emergency medical technicians, anesthesiologist assistants, and diagnostic medical sonographers. Each profession having specific accreditation process and review board
  • Accrediting Bureau of health education schools (ABHES) does both institutional accreditation of schools of allied health and program- specific accreditation. (example)
  • Commission on Accreditation for Health Informatics and Information Management Education (CAHIM)-provides accreditation for programs that lead to the registered health information technician (RHIT) and registered health information administrator (RHIA) (example)
72
Q

Utilization and review (Utilization and Review Accreditation Commission (URAC))

A
  • An agency that provides accreditation and establishes standards for health care delivery
  • have health plan accreditation
  • health utilization management standards are designed to ensure that organizations conducting utilization management follow a process that is clinically sound and respects patients’ and providers’ rights.
73
Q

Copayment

A

fees are flat fees that insurance plan subscribers pay for certain medical services. For example, a subscriber might be required to make a $20 co payment for each visit to a physician’s office

74
Q

Coinsurance

A

refers to the amount of money insurance plans members must pay out of pocket, after the insurance plan pays its share. For example, a plan may agree to pay 80 percent of the cost for a surgical procedure, and the subscriber must pay the remaining 20 percent

1430-59 Legal Principles of Health Information (8 decks)

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