HIM TEST 1 Flashcards
Authorizing the Government to monitor the purity of foods and the safety of medicines
Food and Drug Act(FDA)
Founded to improve the quality of care for surgical patients by establishing standards for surgical education and practice.
American College of Surgeons(ACS)
established a group insurance plan contract with Metropolitan Life Insurance Company, which provided 180,000 employees with hospitalization and surgical benefits
General Motors
Did not include disability coverage or medical benefits. It did include unemployment insurance, old-age assistance, aid to dependent children, and grants to states to provide various forms of medical care
Social Security Act(SSA)
Forerunner of the Centers for Disease Control and Prevention
Communicable Disease Center(CDC)
Provided federal grants to modernized hospitals that had become obsolete due to lack of capital investment throughout the period of the Great Depression and World War II. In return for federal funds, facilities agreed to provide free or reduced-charge medical services to persons unable to pay.
Hill-Burton Act(Hospital Survey and Construction Act)
Created as an independent, not for profit organization whose primary purpose is to provide voluntary accreditation
Joint Commission Accreditation of Hospitals(JCAH)
President Eisenhower created this department and the cost of hospitals doubled in the 1950s
Health, Education, and Welfare(HEW)
Funded projects for testing and demonstrating new and improved services in nursing homes, home care services, and central information and referral centers, and provided additional personnel to serve the chronically ill and aged. It also funded the construction of nursing homes and the establishment of voluntary health planning agencies at the local levels.
Community Health Services and Facilities Act
Provides medical and supports services to migrant and seasonal farm workers and their families
Migrant Health Act
Becoming Americas first widely publicized official recognition that cigarette smoking is a cause of cancer and other serious diseases
Surgeon General’s Report on Smoking and Health
Helps people 65 years or older, certain younger people with disabilities, and people with End-Stage Renal Disease(ESRD)
Medicare
Joint Federal and state program that helps with medicare costs for some people with low incomes and limited resources
Medicaid
Created to improve the health of people who live in communities without access to primary healthcare
National Health Service Corps
Amended the Public Health Service Act to more effectively carry out the national effort against cancer.
National Cancer Act
Required that drug and alcohol abuse patient records be kept confidential and not subject to disclosure except as provided by law
Federal Drug Abuse and Treatment Act
Authorized Veterans Affairs(VA) to establish the Civilian Health and Medicaid Program of the Department of Veterans Affairs to provide healthcare benefits to dependents of veterans rated as 100% permanently and totally disabled as a result of service-connected conditions, veterans who died as a result of service connected conditions, and veterans who died on duty with less then 30days of active service
Veterans Healthcare Expansion Act
Authorized federal grants and loans to private organizations that wished to develop health maintenance organizations(HMOs), which are responsible for providing health care services to subscribers in a given geographic area for a fixed fee.
Health Maintenance Organizations Assistance Act
Implemented to protect the privacy of individuals identified in information systems maintained by federal government hospitals(e.g. Military Hospitals) and provides access to records concerning themselves.
Privacy Act
Implemented to facilitate ongoing assessment and management of health care services, requiring hospitals to conduct continued-stay reviews to determine the medical necessity and appropriateness of medicare and medicaid inpatient hospitalizations
Utilization Review Act
requires that every patient presenting to the ER must be triaged and assessed by a healthcare provider regardless of ability to pay
Emergency Medical Treatment and Labor Act EMTALA
Signed into law, providing for a separate Department of Education.
Department of Education Organization Act
Replaced PSROs with Peer Review Organizations(PROs), which were statewide utilization and quality control peer review organization, incorporated a focused second-opinion program, which referred certain cases for diagnostic and treatment verification.
Peer Review Improvement Act
Established the first Medicare prospective payment system, which was implemented in 1983, Diagnosis-related groups(DRGs) required acute care hospitals to be reimbursed at a predetermined rate according to discharge diagnosis
Tax Equity and Fiscal Responsibility Act(TEFRA)
Allowed former employees, retirees, spouses, domestic partners, and eligible dependent children who lose coverage due to certain qualifying events the right to temporary continuation of health coverage at group rates
Consolidated Omnibus Budget Reconciliation Act(COBRA)
Required PROs to report cases of substandard care to licensing and certification agencies
Omnibus Budget Reconciliation Act(OBRA)
Established the National Practitioner Data Bank(NPDB), which contains information about practitioners’ credentials, including previous medical malpractice payment and adverse action history.
Federal Health Care Quality Improvement Act
Ensured that residents of nursing homes receive quality care, required the provision of certain services to each resident, and established a Residents’ Bill of Rights
Nursing Home Reform Act
Providing Healthcare to the homeless
Mckinney Act
Established quality standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results regardless of where the test was preformed
Clinical Laboratory Improvement Act(CLIA)
Mandated the reporting of ICD-9-CM diagnosis codes on medicare claims
Medicare Catastrophic Coverage Act
Required consumers to be provided with informed consent, information about their right to make advance health care decisions, and information about state laws that impact legal choices in making health care decisions
Patient Self-Determination Act
It mandates administrative simplification regulations that govern privacy, security, and electronic transactions standards for health care information. Also, protects health insurance coverage workers and their families
Health Insurance Portability and Accountability Act(HIPAA)
Combats fraud and abuse in health insurance and health care delivery by alerting users to conduct a comprehensive review of a practitioners, providers, or suppliers past actions
Healthcare Integrity and Protection Data Bank(HIPDB)
Health insurance program for infants, children, and teens that covers health care services such as doctor visits, prescription medicines, and hospitalizations
State Children’s Health Insurance Program(SCHIP) or Title XXI of the Balanced Budget Act
Signed into law, making it possible for millions of Americans with disabilities to join the workforce without fear of losing their medicaid and medicare coverage
Ticket to Work and Work Incentives Improvement Act
Requires implementation of a $400-billion prescription drug benefit, improved medicare advantage benefits, faster medicare appeals decisions, and more
Benefits Improvement and Protection Act(BIPA)
Provides medicare recipients with prescription drug savings and additional healthcare plan choices, modernizes medicare by allowing private health care plans to compete, and requires that medicare trustees analyze the combined fiscal status of the medicare trust funds and warn congress and the president when medicare’s general fund subsidy exceeds 45 percents
Medicare Prescription Drug, Improvement, Modernization Act(MMA)
Created the Medicaid Integrity Program(MIP), which is a fraud and abuse detection program
Deficit Reduction Act
Amends Title IX of the Public Health Service Act to provide for improved patient safety and reduced incidence of events adversely affecting patient safety
Patient Safety and Quality Improvement Act
Authorized implementation of a physician quality reporting initiative(PQRI), which established a financial incentive for eligible professionals who participate in a voluntary quality reporting program
Tax Relief and Health Care Act(TRHCA)
Prohibits group health plans and health insurance companies from denying coverage to a healthy individual or charging higher premiums based solely on a genetic predisposition to development of a disease in the future. Also, bars employers from using genetic information when making hiring, firing, job placement, and promotion decisions
Genetic Information Nondiscrimination Act(GINA)
Authorized an expenditure of $1.5 billion for grants for construction, renovation equipment , and the acquisition of health information technology systems.
American Recovery and Reinvestment Act
Focuses on private health insurance reform to provide better coverage for individuals with pre-existing conditions, improve prescription drug coverage under medicare and extend the life of the medicare trust fund by at least 12 years
Patient Protection and Affordable Care Act(PPACA)
Amended the PPACA to implement health care reform initiatives such as increasing tax credits to buy healthcare insurance, eliminating special deals provided to senators, closing the medicare “Donut Hole”, delaying taxes on “Cadillac” health care plans until 2018. implementing revenue changes and so on
Health Care and Education Reconciliation Act(HCERA)
Amended the Public Health Service Act to establish an Office of National Coordinator for Health Information Technology within HHS to improve healthcare quality, safety,and efficiency
Health Information Technology for Economic and Clinical Health Act(HITECH Act)
- point of first contact
- these providers treat minor diseases, illnesses, and wellness visits
Primary Care
when a patient requires a medical specialist like if they have a disease that needs a second opinion
Secondary Care
- highly specialized medical centers
- highly specialized physicians with a range of services provided
- like having to have surgery or scans
Tertiary Care
Income is reinvested in the facility
- Government
Supported or public hospitals(EX: supported by local, regional, or federal taxes and operated by local, state and federal governments
- voluntary hospitals(EX:operated by religious or voluntary groups)
Non-For-Profit Facilities
Privately owned and income in distributed to share holders and owners
Proprietary Hospitals are owned by both corporations, partnerships, and foundations(EX: Humana(Insurance), Physicians, and any type of hospital). They may own nursing homes as well as hospitals and other facilities
For-Profit Facilities
- Responsible for the hospitals operation
- Responsible for the quality and care administered to patients
- Hospital organization, management, control and operation, appointing medical staff
- Abiding by the hospitals written constitution and bylaws
- Conducting Regular meetings
- Hiring an administrator; authority and responsibility for the hospital polices
- ensuring well-qualified personnel are employed to carry out the function of the hospital
- providing a mechanism, assisting employees in addressing physical and mental health issues
- maintaining standards of professional work and requiring that the medical staff function good
Governing Board Responsibilities
consists of licensed physicians and other licensed providers as permitted by law who are granted clinical privileges
-example: nurses, physician assistants
medical staff
physicians who work in the hospital setting and treat patients who are receiving hospital-based care
Hospitalists
delivers most hospital medical services, performs significant organizational and administrative medical staff duties
Active
advancement to active category is being considered
Associate
includes highly qualified practitioners available as consultants when needed
Consulting
admits and occasional patient to the hospital
Courtesy
includes former members who are honored with emeritus status and other outstanding practitioners whom the medical staff wish to honor
Honorary
specialist doctors who see patients at specific times
senior consultants
senior doctors who supervise residents, interns and students
registrars
look after patients on the ward and are in training for specialization
Residents
completed their studies and are now finishing their final year in hospital
Interns
undergraduate medical students.
Student Doctors
runs the ward
nurse unit manager
helps the nurse unit manager to run the ward and acts as the manager when the nurse unit manager is off site
associate nurse unit manager
highly skilled nurses with an advanced level of training
nurse practitioners
clinical nurse specialists, clinical nurse consultants, clinical nurse educators, triage nurses, emergency department nurses
specialist nurses
provide a high level of day-to-day care and perform some minor procedures
registered nurses
provide basic medical care under the supervision of more senior nurses.
enrolled nurses
