Paging Dr. Precedent
What does Phillips v. Hillcrest Med Ctr. Say and hold?
Talks about the EMTALA screening requirement. He was properly screened and just misdiagnosed but the second doctor gave same diagnosis. This was not a violation of EMTALA, but possibly a state medical malpractice claim.
Where did the ACA come from? What did it aim to do?
The Affordable Care Act was signed into law in 2010 by Obama. It was a consolidation of two different laws. It was to help make it easier for people to get health insurance and then also stay on it, which in turn helps you get healthcare!
What is the cause of action for when a Dr. with a duty to treat stops treating the patient? What are the elements of that COA?
Patient abandonment.
The physician leaves a patient at a critical stage of the diagnosis without giving proper or sufficient notice that enables them to procure another medical attendant.
(People in health law who think it is an independent field will often argue this).
What was the first federal law signed in to try and help the mental health disparities, and what did it do?
President Clinton's 1996 Mental Health Parity Act (MPHA) which imposed--on large group health plans that voluntarily provided mental health benefits--limits on the lifetime and annual spending limits for physical and mental health. (excluded substance abuse and addictive disorders).
What are the 6 main EMTALA requirements? Can you give an example of the second requirement!
(1) Medical screening requirement, (2) Stabilization requirement, (3) Appropriate transfer requirement, (4) No delay requirement, (5) The recipient hospital requirement, (6) No adverse action requirement.
If a mom is giving birth, you need to deliver the baby and make sure mom is healthy.
Which case tells us CL ways to stop treating a patient or withdraw from the case, and what are they?
Ricks v. Budge
(1) Cessation of the necessity which gave rise to the relationship, (2) The discharge of the physician by the patient (or mutual agreement), (3) OR by withdrawal from the case by the physician after giving reasonable notice so as to enable the patient to secure medical attention.
From the ACA Subtitle C, Section 1201 what are the only four things that can allow you to be charged more?
(1) Whether such plan covers an individual or family, (2) Geographical location, (3) Age (except that rate shall not vary by more than 3 to 1 for adults, (4) and tobacco use, (except that rate shall not vary by more than 1.5 to 1).
What was the second Mental Health disparity law and what did it do?
In 2008 George W. Bush signed into law the Mental Health Parity and Addiction Equity Act (MHPAEA). It was still not a mandated benefit law but it did add a bit more non-quantitive aspects (FINISH) and it added the substance use and addictive disorders.
Any there any modules later down the line that go against module 5? If so, what are they?
Yes, Modules 6 and 7 go back on 5 and are kind of the exceptions.
In module 6 we see that sometimes things can be reported without the consent of the patient and in module 7 sometimes things can be done without consent because we put the public welfare over individual autonomy.
True or false: OK law says; any person, regardless of age, has the capacity to consent to examination and treatment by a health care provider for any sexually transmitted infection.
TRUE! We care about minors getting treatment!!!!
What is the Oregon CL test for whether or not a Dr. has a duty to a patient they haven't physically seen? Case name?
Mead v. Legacy Health Sys.
Whether the physician either knows or reasonably should know they are diagnosing or treating a patient. (Can be express or implied).
What were the five sections in ACA 1001?
(1) No lifetime or annual limits, (2) Prohibition on recessions (they can't drop you for something, unless fraud or misrepresentation), (3) coverage of preventative health services, (4) Extension of dependent coverage until adult child is 26 (unless married or has a child that child is not covered), (5) An effective appeals process shall be implemented.
Which hospitals are regulated by EMTALA? Include the details *
Applies to Medicare participating hospitals with dedicated emergency departments. There are three ways to have a dedicated emergency department, (1) licensed by the state, (2) hold your self out to the public as one (name, signs, advertising), (3) 1/3 of outpatient visits are for treatment of an emergency medical condition.
What are the four CL tests to figure out if someone has a MHC or a physical condition?
(1) The "who is the treating provider" test (FL), (2) The "nature of the treatment" test (NY), (3) The "origin of the patients illness" test (ARK), (4) The "patient symptom" test
What is the difference between Texas and Nevada informed consent law?
Texas micromanages and is very hands on/strict. Nevada is very hands off.
What does the St. Anthony Hospital v. HHS case tell us? Holding?
Civil penalties depend on how big the hospital is. A hospital with less than 100 beds, not more than $25,000 and if bigger then $50,000.
In Subtitle D, 1302, for the health plans that must comply with the ACA, you must also comply with the essential health benefits. Who must comply with the EHB and what are they?
There are 10 essential health benefits that small group plans and individuals plans have to comply with. (Excludes large group health plans, self-insured, and people grandfathered in). The 10 EHBs are: (1) Ambulatory patient services, (2) emergency services, (3) hospitalization, (4) maternity and newborn care, (5) mental health and substance use disorder services, (6) prescription drugs, (7) rehabilitative services, (8) laboratory services, (9) preventive and wellness services and chronic disease management, (10) pediatric services (including oral and vision care).
What did Scott v. Bradford and Allen v. Harrison say? (Both OK cases on informed consent).
Scott v. Bradford states that
Allen v. Harrison states that failure to obtain informed consent is not limited to surgical procedures.
Both of these cases state there is a duty to disclose and that without it, consent would mean nothing.
When was the first time physical and mental health benefits were defined?
In Clintons 1996 MHPA Act.
What are the eight situations in OK, where kids have the legal capacity to consent to their own treatment and parents don't have to know?
#1: Any minor who is married, has a dependent child, or is emancipated
What is the famous legal principle from Schloendorff v. Society?
Every human being of adult years and sound mind has a right to determine what shall be done with his own body; and a doctor who performs an operation without his patients consent, commits a trespass, for which he is liable in damages. Schloendorff said this was assault, but now we usually use battery, and negligence. (Negligent failure to obtain informed consent).
In the ACA subtitle C, Section 1201, one of the five provisions talks about prohibiting discrimination against individual participants and beneficiaries based on health status. What are the times they cannot discriminate against you for health insurance?
(9) -- (1) Health status, (2) medical condition, (3) claims experience, (4) receipt of health care, (5) medical history, (6) genetic information, (7) evidence of insurability, (8) disability, (9) any other health status related factor determined appropriate by the secretary.
Competing disclosure standards for informed consent and which two cases give two standards?
- Culbertson v. Mernitz gave us the objective doctor standard (Dr. getting consent must do what another reasonably prudent doctor would)
- Canterbury v. Spence gave us the objective patient one, which says you must disclose what the reasonably prudent patient would want to know.
Obama 2010 ACA for MH
Still dont know this.
The Texas Medical Disclosure Panel is created to determine which risks and hazards must be disclosed to pts. They create lists of certain procedures and what needs to be disclosed. If a Dr. who does an epidural discloses 1-7 of the risks but fails to disclose 8, and the pt suffers pain, can they win on an IC issue?
Yes, because the Dr. was required to warn about 1-8.