Final Review Flashcards
encompasses all of the legal principles governing the activities and procedures of federal, state and local governmental agencies, boards, commissions, and other similar entities
Administrative Law
replaced by an attitude of trust in the ability and integrity of government to protect the public from unethical and incompetent businesspersons
Doctrine of laissez faire
provides a statutory framework for most decision making by federal administrative agencies
The Administrative Procedure Act
contains a # of exceptions authorizing release of personal info about individuals to federal agencies
The Privacy Act
consisting of statues, case law, and administrative regulations and rulings, has as its primary purpose the promotion of competition among private sector businesses that benefits the general public (fair competition)
Antitrust Law
prohibits business agreements or arrangements that unreasonably interfere with interstate commerce and prohibits the willful acquisition or maintenance of monopoly power in a given market or the attempt to achieve such control
The Sherman Act
prohibits specific anticompetitive business practices, including unjustified price discrimination by sellers and unreasonable mergers and acquisitions, among other practices
The Clayton Act
created by Federal Trade Commission along w/ Department of Justice, administers federal antitrust law
The Federal Trade Commission Act
permissible and impermissible physician self-referral for ancillary services; prevents referrals if physician has financial relationship to that referall
Stark I & II
“let the buyer beware”
caveat emptor
advertisements that compare the relative quality of services offered among competitors
comparative competitor claims
wrongs committed against the legitimate proprietary business interests of individuals, partnerships, or corporations
Business torts
involves the wrongful communication of false info about a businessperson or entity that causes injury to the victim’s business reputation or interests
Business disparagement
forms the foundation for all commercial transactions, including purchases of goods and services (including patient care services) and employment relationships
Contract Law
the mutual agreement of parties to a bilateral contract to be bound to performance
Mutuality of assent
the inducement that causes a party to a contract to allow himself or herself to become legally bound to perform under the agreement
Consideration
to validate a contract made by a minor, the minor normally must continue to perform under a contract after the minor achieves the age of majority
Ratification
there is no agreement of assent to be bound by the other party; “analogous to a contract”
Quasi Contract
courts asked to interpret written contracts will only interpret the understandings memorialized by the parties to the agreement in writing
Four-corners Doctrine
exists to protect the integrity of written contractual agreements and, in part, to give legal effect to the clear meaning of the parties as stated in their written agreement
Parol evidence rule
restates that there are no contractual understandings or obligations that are not included in the written agreement
Integration clause
provides sufficient monetary recovery only to restore the aggrieved party to the status quo ante, or the position he or she occupied before beginning performance under the contract; only for labor and materials expended
Restitution damages
operate not only to restore a contract plaintiff to the status quo ante but also to give the aggrieved party reasonable monetary damages to compensate for the breach
Reliance damages
full “benefit of the contractual bargain” as contemplated by the parties when they formed the contract; incidental damages and consequential damages included
Expectancy damages
preagreed default damages specified in a contract
Liquidated damages
Who must comply with HIPAA?
health care systems
plans
providers
clearinghouses
insurance that covers insured persons and businesses against losses from claims and litigation brought by parties against policyholders for monetary damages incident to personal injury or property damage for which the policyholder are legally responsible to pay
General Liability Insurance
a health care professional is indemnified for covered adverse incidents that occurred while the professional was insured by the insurer, irrespective of when a claim is filed
Occurrence coverage
claims brought against insurers for covered adverse incidents must be made while the health care professional is still insured by the insurer in order to be payable under the policy
Claims-made liability
to ensure that residents of nursing homes receive quality care that will result in their achieving or maintaining their “highest practicable” physical, mental, and psychosocial well-being.
Nursing Home Reform Act
prohibits the use of physical restraints on long-term care residents, except as adjuncts to treatment for specific medical conditions; creates a set of national minimum
set of standards of care and rights for people living in certified nursing facilities
Omnibus Budget Reconciliation Act
requires health care facilities to report incidents involving serious patient injury, illness, or death resulting from defective medical equipment
Safe Medical Devices Act
designed to strengthen federal regulation of public companies; increase corporate responsibility by making corporate executives and corporate legal counsel personally responsible for accurate public reporting of financial information about their business
Sarbanes-Oxley Act
form of negotiated bribery in which a commission is paid to the bribe-taker as a quid pro quo for services rendered
kickbacks
any delivery and reimbursement system that attempts to control the clients served, the range of benefits and services offered, and costs; capitation
managed care
relieves managed-care organization from having to provide fringe employee benefits as well as from having to meet requirements governing the employer-employee relationship
Contracted-service arrangement/model
failure to provide for a child’s basic needs (physical, educational, emotional)
child neglect
refusal of or delay in seeking health care, abandonment, expulsion from the home or refusal to allow a runaway to return home, and inadequate supervision
Physical neglect
the allowance of chronic truancy, failure to enroll a child of mandatory school age, and failure to attend to a special education need
Educational neglect
such actions as marked inattention to the child’s needs for affection, refusal of or failure to provide needed psychological care, spousal abuse in the child’s presence, and permission of drug or alcohol use by the child
Emotional neglect
public official who acts as an impartial intermediary between the public and gov. or bureaucracy, or an employee of an organization who mediates disputes b/w employees and management
Ombudsperson
