Health Care Law Flashcards
Groups Health Care Law impacts
1) Health Care Providers
2) Health Care Workforce
3) Health Care Organizations
4) Payers and Payees
5) Consumers
6) Health Care Agencies
Influences on patient ratios, practice acts, professional boards, licensure requirements, standards of care, malpractice insurance rate, etc.
Health Care Providers
Influences on patient ratios, licensing, scope of practice / practice acts, confidentiality, privacy, delegation.
Health Care Workforce
Influences on policies and procedures, restraint protocols, medical records access, liability, access to services, EMTALA, HIPAA, licensure
Health Care Organizations
To bill within certain time frame, to bill period (cannot not bill for services if CMS participant), duty to pay for services rendered, contractual obligations
Payers and Payees
Influences on rights to safe care, right to access care, right to privacy, right for informed consent, etc.
Consumers
Influences on policies and procedures, restraint protocols, medical records access, liability, access to services, EMTALA, HIPAA, contractual relationships (medical group, hospital, insurers, etc.), licensure
Health Care Agencies
Social Security Act of 1965
Established Medicare and Medicaid, the government sponsored health insurance plans for the elderly and poor.
ADA (The Americans with Disabilities Act)
A broad civil rights statue that protects people with physical or mental disabilities. Prohibits discrimination in areas of employment, state and local government services, public accommodations, commercial facilities, and transportation. It also extensively protects individuals, both patients and health care employees, regarding HIV status, especially regarding whether the individual discloses his or her sero-status.
EMTALA (The Emergency Medical Treatment and Active Labor Act)
The ‘anti-dumping’ law, requires that when an individual presents to a hospital with an emergency room for treatment, the hospital must conduct a medical screening within the facility’s capacity.
Advance Directives
Include living wills, health care proxies, and durable power of attorney for health care reasons.
Healthcare Proxies or DPAHC (A part of Advance Directives)
Included in living wills. The wishes in the event of a terminal illness or if a condition develops. (DNRs/ DNIs/ etc.)
Uniformed Anatomical Gift Act
Allows for individuals to declare their choice of whether or not they would like their organs, up to and including the entire body, donated upon their death.
HIPAA (Health Insurance Portability and Accountability Act)
The law specifies that privacy, which is the right to prevent personal information from being disclosed and confidentiality, which protects private patient’s information once it has been disclosed, must be honored.
Restraints
Sometimes required to maintain a patient’s safety or the safety of others in the event of physically assaultive patient.
What are the 3 criteria for use of restraints?
1) LIP order
2) Less restrictive means were unsuccessful
3) To protect patient or others
COBRA (Consolidated Omnibus Budget Reconciliation Act)
Allows an individual to retain his or her insurance even after s/he leaves employment with the company who provided such insurance coverage
PPACA (Patient Protection and Affordable Care Act aka Obamacare)
Reshaped healthcare in a number of ways. It has expanded access to care by expanding insurance coverage options for Americans
What is the Good Samaritan Laws
Protect nurses when/if they assist a person in need in the community in an emergency situation. The nurse is not held liable if s/he provides care consistent with his or her training, scope of practice, and experience and the person develops complications as a result of the nurse’s actions
Does New Mexico make it a requirement for a nurse to assist in an emergency situation?
No
Public Health
Laws are established for the promotion of the public’s health and safety.
Uniform Determination of Death
Dictates under which circumstances are individuals considered to be dead
What are the two distinct standards of Uniform Determination of Death?
1) Cardiac
2) Whole Brain
Autopsy
Is a postmortem, or after death, examination of the body.
Physician Assisted Suicide
The patient must have a terminal illness and must request assistance in writing.
True or False: New Mexico allows Physician Assisted Suicide?
False
Consent
Laws mandate that a patient provide informed permission for a procedure, such as surgery
Tort Law
Shapes and defines our patient care quality parameters: -negligence, malpractice cases
Constitutional Law
Of or relating to the system of beliefs and laws that govern a country : of or relating to a constitution
Negligence
Is a tort law, meaning that it involves a civil wrong against a person or property
Malpractice
Malpractice is a special type of negligence
What 4 elements must be satisfied to be considered malpractice?
1) Duty
2) Breach
3) Harm
4) Causation