Medical Assisting Chapter 5 Legal Issues

law

system of rules, usually enforced through a collection of institutions commonly recognized as having the authority to do so

federal law

made by the United States Congress when it passes legislation (ex. Patient Protection and Affordable Care Act)

supremacy clause

in the U.S Constitution; laws created by Congress apply to everyone in the United States

state law

made by state legislatures; applies to everyone within the state but not to those who don't live or work there

jurisdictions

areas such as counties, cities, townships, etc. that can pass resolutions or ordinances that govern conduct in those areas

United States Supreme Court

makes" law by interpreting the constitution

common law (case law or law of precedent)

based on custom and usage; almost all of it has been enacted into statues with modern variations

misdemeanors

punishable by imprisonment in a jail for less than one year, assessment of a fine, or both

felonies

punishable by imprisonment in a state prison for more than one year (and sometimes punishable by death)

standard of proof

measure by which evidence is judged to show a "preponderance of evidence" in a civil action and "beyond a reasonable doubt" in a criminal case

beyond a reasonable doubt

standard of proof in a criminal case; prosecution must prove that the defendant committed the act as determined by a jury of the defendant's peers (12 people must absolutely agree that the act was committed and that the defendant committed it)

wrongful death

death of a human being as the result of a wrongful act of another person

preponderance of evidence

standard of proof in civil court; based on the more convincing evidence and its probable truth or accuracy

murder

a felony; "unlawful killing of another with malice aforethought

manslaughter

unlawful killing of a human being without malice

voluntary manslaughter

upon a sudden quarrel or heat of passion

involuntary manslaughter

in the commission of an unlawful act or without due caution and circumspection, of a lawful act which might produce death

robbery

unlawful taking of money or good of another from his or her person or in immediate presence by force or itimidation

burglary

taking of money or property belonging to another, without the presence of a victim

tort

any wrongful act, damage, or injury done willfully, negligently

punitive damages

awarded in a lawsuit as a punishment and example to others for malicious, evil or fraudulent acts

compensatory damages

recovered in payment for actual injury or economic loss

intentional torts

include libel and slander, trespass and intentional infliction of emotional distress

libel

written defamation

negligence

guilty of neglect; lacking due care or concern

standard of care

the watchfulness, attention, caution and prudence that a reasonable person in the circumstances should exercise

factors pointing to negligence

1. a duty of care owed by the defendant to the plaintiff
2. the defendant must have committed a breach of that duty
3. the plaintiff must have suffered harm
4. the harm must be a result of the defendant's breach of duty

affirmative duty

when two people have a particular relationship to one another, they are responsible to carry out certain duties for each other

factors pointing to medical malpractice

1. there is a relationship between the provider and the patient
2. that relationship created a duty of the provider toward the patient
3. the duty was a nature of professional standard of care
4. the provider breached the duty to the patient
5. the patien

relationship

created by the offer of care by the provider and an acceptance by the patient

duty

exs. if the provider knows of an abnormal test result or observation on examination, he/she must tell the patient; to diagnose medical conditions and to treat known medical conditions

breach of duty

provider failed to act upon the duty he/she owed the plaintiff

causation

failure of the provider to act according to duty, or a failure to act in a manner consistent with providers in similar circumstances (leading to the injury)

statute of limitations

how long after the situation the person can bring their claim; in medical malpractice claims it is typically 2 years

offer

made by the provider by holding himself out to provide medical services

acceptance

when the patient makes an appointment, he/she indicates this

consideration

when the patient assures the medical assistant taking the appointment that she has insurance and will pay the co-pay; leads the the forming of a valid contract for care between the patient and the provider

required to form a contract

offer, acceptance and consideration

capacity to enter a contract

patient must be (a) the age of majority as determined by the state in which the contract is formed or (b) an emancipated minor and (c) not the victim of a legal disability (not mentally incompetent or under the influence of drugs that alter the mental sta

consent

can be given by a parent or guardian for a minor, or a person who is the age of majority or an emancipated minor

causes termination of contract

1. mutual consent of the patient and the doctor
2. patient dismissing the doctor
3. the changed circumstance under which care is no longer needed
4. provider withdrawal from the relationship by providing the patient with written notice with reasonable tim

when providers are compelled to provide care

1. the patient is disabled with HIV
2. the patient has sued the provider group for malpractice and there has not been enough time to notify the patient to seek a new doctor
3. the relationship with the patient has not been continuous, when the abandonment

exception to patient-provider privileged communication

to report child abuse and elder abuse

HIPPA permits disclose of this information

to a family member unless the patient objects; when subpoenaed as part of litigation; when the provider has a legal duty to report, as in cases of abuse or contagious diseases; and when needed for public health activities, law enforcement purposes, or sim

informed consent

must be given before the doctor can treat the patient

Patient Self-Determination Act

requires any health care provider accepting Medicare or Medicaid to inform the patient (1) of his/her right to accept or refuse treatment, (2) of his/her rights regarding advance directives under state law, and (3) of any hospital/provider policies regard

advance directives

a living will; a document, written in advance, that states the patient's wishes regarding end-of-life care

living will

advance directive; a document, written in advance, that states the patient's wishes regarding end of life care

power of attorney

legal document authorizing a person to act as another's attorney, legal representative, or agent

included in an adequate medical record

1. documentation of each patient encounter, including the reason for it, relevant history, exam findings, and prior test results; also include a clinical impression/diagnosis, a plan for care and the date and legible identity of the provider
2. past and p

property right

the entitlement to anything that is owned by a person or entity

when medical records should be changed

only when it is necessary to make the record more accurate or more complete

what to do if you must change a medical record

include the time and date of change along with language specifically pointing out the change

Health Insurance Portability and Accountability Act

passed by Congress to ensure (among other things) that an employee leaving his/her job could take at least some insurance coverage with her/her

what HIPPA means for the medical assistant

understanding that the material in the medical record is part of a privileged communication between the provider and the patient

mandatory release of record

in the case of all infectious diseases (measles, STDs, etc), certain crimes (rape, domestic abuse, elder abuse, and child abuse), or when ordered by the court to release medical records when the health status of either defendant or plaintiff is at issue t

Occupational Safety and Health Administration

goal is to ensure that employers have safe work environment for employees, which do not have hazards such as extreme cold or heat, toxins, danger from mechanical devices, or noise that would damage a person's hearing

Clinical Laboratory Improvement Amendments

legislation dealing with the operation of a clinical laboratory

Food and Drug Administration

1. to protect the public's health by ensuring that safe pharmaceutical products and diagnostic devices make it to the market in a timely fashion 2. to ensure ongoing effectiveness and safety of those products by monitoring their use in the market 3. to he

Drug Enforcement Administration

has broad enforcement power over the distribution of narcotic s and other drugs, both legal and illicit; authority over providers prescribing certain pain killers as well as authority to conduct search and seizure operations of international smugglers dea

Office of Diversion Control

where a provider applies for the DEA registration that permits them to handle, dispense, and prescribe various controlled substances (registration last for three years and the provider must apply for amended registration if he/she relocates his/her office

Good Smaritan Acts

protects individuals who decide to provide help and serve those who are injured