Criminal Law
Definition: the area of law that addresses possible illegal actions taken and must be proven in court beyond reasonable doubt
Assault and Battery
Definition: refers to the wrong act of causing someone to reasonably fear imminent harm
Slander
Definition: the action or crime of making a false spoken statement damaging to a person's reputation
Scope of Practice
Definition: a process of communication between you and your health care provider that often leads to agreement or permission for care, treatment, or services ethics
Termination of Coverage
Definition: when the consumer has chosen a plan and effectuated coverage by paying the first premium payment and ends the coverage effective after the date the coverage was effectuated
Civil Law
Definition: the body of law that defines conduct perceived as threatening to, harmful to, or otherwise endangering the property, health, safety, and welfare of people
Invasion of Privacy
Definition: a doctor sharing a patient's medical records with someone who is not authorized to see them
Libel
Definition: a defamatory statement in writing or other visible forms
Power of Attorney
Definition: a type of advance directive that gives a person (called a proxy) the authority to make medical decisions for another person if that person is not able to make their own decisions
Pre-Existing Condition
Definition: a medical condition that started before a person's health insurance went into effect
Torts
Definition: when a medical professional acts in a negligent manner and injures someone in their care
False Imprisonment
Definition: an intentional act to restrict a patient's movement unlawfully
Contract
Definition: the costs of employer-furnished first aid and medical facilities, including personnel or retainer fees for nurses and physicians that are not allocated to individual claims
Living Will
Definition: a written, legal document that spells out medical treatments you would and would not want to be used to keep you alive, as well as your preferences for other medical decisions, such as pain management or organ donation
Omnibus Budget Reconciliation Act (OBRA)
Definition: expanded the definition of "employment” for Social Security coverage and FICA tax purposes
Malpractice
Definition: 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
Abuse
Definition: the actions or inactions of an individual's caregiver or parent inflicting physical, sexual, or emotional harm on the individual
Breach of Contract
Definition: when one or more of the terms of the contract are violated
Denial of services
Definition: 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
Negligence
Definition: 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
Defamation
Definition: a false statement of fact, published to a third party
Consent Form
Definition: a process of communication between you and your health care provider that often leads to agreement or permission for care, treatment, or services
Denied Payment
Definition: when a healthcare insurance payer refuses to reimburse a provider for services rendered to a patient according to their benefits