Chapter 5
Criminal Law Def.
Criminal law is the area of law that addresses possible illegal actions taken and must be proven in court beyond a reasonable doubt. Healthcare providers can be found liable or responsible for their actions. Three areas of concern revolve around patients, billing and coding, and ethical dilemmas.
Civil Law Def.
Civil law refers to laws and regulations that govern the interactions between private citizens, or in the case of healthcare, between the practitioner and patient. It deals with the wrongdoing or negligence of a practitioner toward a patient, with the result of harm to the patient.
Torts Def.
But in general, know that a “tort” is a fancy way of saying “malpractice.” Medical torts are triggered when a healthcare professional or organization causes patient injury. The aggrieved party files a suit and asks for compensation due to the damage.
Malpractice Def.
Medical malpractice is defined as any act or omission by a physician during the treatment of a patient that deviates from accepted norms of practice in the medical community and causes an injury to the patient.
Negligence Def.
The definition of medical negligence is when a patient does not receive appropriate care in line with the high standards expected of those in the medical or healthcare profession and experiences direct harm or the worsening of their condition as a result.
Assault and Battery Def.
Essentially, assault is attempted battery. Medical battery is similar to battery, but the harm occurs in a medical setting and includes harmful or offensive touching of a patient by a medical professional.
Invasion of Privacy Def.
Sharing the results of a test in front of family members or other patients without your permission. Taking pictures of an undressed patient under anesthesia. Mentioning a patient's medical history in a document that is open to the public.
False Imprisonment Def.
False imprisonment, as it applies in the health care delivery environment, involves an allegation that a healthcare professional or someone employed by the provider acted intentionally to restrict a patient's movement unlawfully.
Abuse Def.
Abuse and neglect refer to the actions or inactions of an individual's caregiver or parent inflicting physical, sexual, or emotional harm on the individual.
Defamation Def.
Defamation by a patient or their representative relative to the care received or not received from a doctor or hospital is commonly understood to be a false statement of fact, published to a third party. This is harmful to the reputation of the doctor or hospital
Slander Def.
any care that results in physical harm, pain, or mental anguish. Slander. the action or crime of making a false SPOKEN statement damaging to a person's reputation.
Libel Def.
libel is when he makes a report on the health of a patient. to another person. In most cases, the report is made at. the request of, with the consent of, or in the interests of, the patient, and is therefore privileged in so far as it is.
Contracts Def.
Contracts are structured promises. A patient commits to pay the doctor's reasonable price in exchange for the doctor using her best judgment in treating them. Beyond making promises, another way to see a contract is as a record of a relationship.
Breach of Contract Def.
To make sure no one gets hurt, the doctor may have the patient sign a contract to behave appropriately while at the facility and to cooperate with staff. If the patient breaches this contract, he will no longer be treated there.
consent form -A document with important information about a medical procedure or treatment, a clinical trial, or genetic testing. It also includes information on possible risks and benefits. If a person chooses to take part in the treatment, procedure, trial, or testing, he or she signs the form to give official consent.
Scope of Practice Def.
“Scope of practice” is defined as the activities that an individual health care practitioner is permitted to perform within a specific profession. Those activities should be based on appropriate education, training, and experience.
Ethics Def.
Ethics serve as the guiding principles for healthcare professionals, ensuring that they prioritize their patients' well-being, treat patients with dignity and respect, and foster trust and confidence in the healthcare system.
Power of Attorney Def.
Conversely, a Health Care Power of Attorney, or healthcare proxy, designates a trusted individual to make healthcare decisions on your behalf should you become incapacitated. This role isn't limited to end-of-life decisions and can encompass any medical decisions that arise during your incapacity.
Living Will Def.
A living will is a legal document that tells doctors how you want to be treated if you cannot make your own decisions about emergency treatment.
Denial of Services Def.
Failure to provide medical treatment: the refusal to provide healthcare to a patient who requires it. Refusal of medical assistance: a patient's voluntary refusal to receive medical care.
Defined Payment Def.
the refusal of an insurance company or carrier to honor a request by an individual (or his or her provider) to pay for healthcare services obtained from a healthcare professional.”
Termination of Coverage Def.
Cancellation occurs during the active life of the policy (i.e., cancellation for non-payment of the premium). Termination occurs when a policy runs its course and is not renewed.
Preexisting Condition Def.
A health problem, like asthma, diabetes, or cancer, you had before the date that new health coverage starts. Insurance companies can't refuse to cover treatment for your pre-existing condition or charge you more
Omnibus Budget Reconciliation Act (OBRA)
Its primary purpose was to improve the quality of care provided by long-term care facilities and to enhance the quality of life of the residents.