Health Care Law Flashcards
EMTALA
- Emergency medical treatment and active labor act
- 1986
- anti-dumping law: can not “dump” your pt either due to unable to pay or other reason
Hospital Survey & Construction Act
(The Hill-Burton Act of 1946)
(“Bricks And Mortar” program)
Hill-Burton Act of 1946
- Funding was given for hospitals’ construction
- Hospital is responsible to provide reasonable care to those who cannot afford to pay
- Funding was stopped in 1990s
COBRA
Consolidated Omnibus Budget Reconciliation Act of 1985
- requires employers with more than 20 employees to offer continuation of health benefits for 18 months to employees who are no longer eligible under the employer’s group coverage due , for example, to retirement or termination.
- The former employee is required to pay the premiums for the continuation coverage
ERISA
- 1974
- Employee Retirement Income Security Act
- Preempts all state tort and consumer protection laws so that employee health benefit plans and self-insurance plans are not state regulated
- Employer has the immunity to self funded insurance plans, immune from State law suit for denial of benefits
Sherman Act
- anti-trust law
- Anti- monopoly
Clay Act
- Anti- trust law
- prohibit market control & lessening of competition by companies
Stark I
1992 Provision Barred self referrals to self labs under Medicare
Stark II
1993, restriction of self referral to cover a range of health services, it applies to both Medicare and Medicaid
Purpose of Affordable Care Act?
Provision to
- expand coverage
- Control health care costs
- Improve the health care delivery system
OSHA does not apply to?
Miners
Workers in the transportation industry
Public employee
Self-employed
Employer are required to maintain medical and exposure records during the employment plus ? Years?
30 years
Access to medical records must be provided at no cost to employee within
? working days ?
15 working days
Mine Safety & Health Act 1977
Each mine must be registered with MSHA
Inspecting every underground mine at least 4 times/year, and every surface mine at least 2 times/year
Jones Act
- Merchant marine Act 1920
- federal statute requires that US flagged ships be built in US, owned by US citizens and registered/licensed in US
- any worker spending more than 30% of their time in service of a vessel on navigable water is a seaman under the Jones Act.
- covered workers are entitled to “ transportation, wages, maintenance, and care”
FMLA 1993
Family and medical leave act 50 or more employees 12 wks unpaid, job- protected leave in a 12-month period for: -birth/adoption of child -care for immediate family -own serious health condition
Couples work in the same company, under FMLE
A combined 12 wk unpaid leave in 12 month
Caring for “covered service member” with serious illness/injury incurred in line of duty on active duty,
Family member entitled to 26 wks of leave in 12 month period
GINA
Genetic information non-discrimination act of 2008
- GINA warning requirement.
GINA warning requirement
Employer requests for medical information must contain a warning to the employee and the healthcare provider specifically directing them not to provide any GI information.
Simply acquiring GI information about an employee can be violation of GINA
SOX
Sarbanes Oxley Act of 2002
Aimed at corporate fraud. Requires intensive business practice reforms
- Financial report certification by CEOs and CFOs
- Public reporting of compensation and profits of CEOs & CFOs
Certificate of Need
- Health planning resources development act of 1974
- Seeks to reduce overall health and medical costs
Stare decisis
Let the decision stands
Res Judicata
The issue has been decideded
Binding
Lower courts must follow
Parens patriae
Permits care to those who cannot take care of themselves when there is threat to self
Eg. Mentally ill or disabled
A law with mandatory reporting and disclosure requirements for group life and health plan is
ERISA
The Employee Retirement Income Security Act of 1974 has mandatory reporting and disclosure requirements for group life and health plans.
It has often been used as a shield against lawsuits by beneficiaries against managed care organizations
Burden of proof for Civil suit
“More probable than not”
- preponderance of evidence
Burden of proof for Criminal suit
Higher burden required
“Beyond a reasonable doubt”
State powers
Police power - threat to self
Parens patriae - threat to society
Police power
Powers of individual states to enact legislation, promulgate regulations to protect public health, safety, morals, and promote public good.
Constitutional test
- Rational basis test
2. Strict scrutiny test
- Rational basis test
Legitimate interest
= reasonably related
- Strict scrutiny test
Fundamental right
= compelling interest and narrowly tailored
Public Health Regulation
Parens patriae (threat to self)
Police power (threat to society)
Search & Seizure
Inspection
State’s rule in public health regulations
Most public health actions at state or local levels.
Federal government’s role in public health regulation
Federal government involved in regulatory (FDA) and non-regulatory activities (CDC)
Funding is used by federal government to regulate state and local activities
EMAC
Emergency Management Assistance Compact
EMAC
Agreements covering liability, reimbursement and response issues when personnel & resources shared across state borders during an emergency.
Congressional Approval 1996, all states adopted.
Sherman act
The first antitrust law passed in US in 1890
Outlawed monopoly or any attempts to monopolize a market or act to restraint trade
Clayton Act
Another antitrust law
It prohibits market control and lessening of competition by companies
Stark law
Governs physician self-referral for Medicare and Medicaid pts
- Referral of pt to medical facility in which physician has a financial interest:
- ownership
- investment
- Structured compensation agreement
False claims act
To address fraudulent billings to federal government
Improper receipt or avoidance of payment to the government
Qui Tam provision of False Claim Act
- Knowledge, past or present fraud and bring suit on behalf of government
- Defendant pays plaintiff expenses if plaintiff wins
- Reward: 15-30% of funds recovered
- Employee protected from retaliation
Tort law
Civil wrong
Negligence
Failure to act as reasonable person would under similar circumstances
Gross Negligence
Behavior which is willful, wanton, or with reckless disregard. Extreme departure from ordinary care.
Battery
The offensive touching of another without consent
Assault
Somebody hit you with anger
Darling vs. Charleston Community Memorial Hospital (1965)
Malpractice liability
- 18 yo football player
- fractured leg
- developed complication
- amputated leg
- hospital was liable to monitor the credentials and competency of physicians
In re Quinlan (1976)
Termination of life support
- 21 yo in comatose vegetative state
- parents petitioned for the right to refuse treatment and turn off the respirator
- the Quinlan case established pt’s right of self-determination.
Tarasoff v. Regents of the University of California (1976)
Duty to warn
Roe v. Wade (1973)
Abortion
- established the legal right to first and second-trimester abortion in the US. – - State can restrict third-trimester abortion, but not if the life or the health of the mother is in danger.
