Health Law: Ch.2-9

Front 1

Statutory law

Back 1

law that emanates from legislatvie bodies: congress, state legislators, city councils. Can trump common law

Front 2

Common Law

Back 2

derived from judicial decisions. Roots in English common law.

Front 3

Administrative Law

Back 3

public law (rules and regulations) issued by administrative agencies to administer the enacted laws of the feds and states.

Front 4

Legislative Branch

Back 4

enacts, amends, repeals existing laws

Front 5

Executive branch

Back 5

administers and enforces the law

Front 6

Judicial

Back 6

resolve disputes in accordance with the law

Front 7

precedent

Back 7

judicial decision that can be used as a standard for other cases.

Constitution sets the precedent for all other laws

Front 8

res judicata

Back 8

"the thing is decided" Once a case is decided, it's done. No more appeals, whining etc.

Front 9

stare decisis

Back 9

a decision for one case holds true for other similar ones

Front 10

line item veto

Back 10

is a special form of veto that authorizes a chief executive to reject particular provisions of a bill enacted by a legislature without vetoing the entire bill.

Front 11

Tort Law

Back 11

a civil wrong causing someone else to suffer loss or harm.

Front 12

Obj. of Tort Law: Culpatility

Back 12

Find fault for wrongdoing.

Front 13

Obj. of Tort Law: Deterrence

Back 13

... of wrongful acts thru theassessment of monetary damages.

Front 14

Obj. of Tort Law: Preservation

Back 14

... of peace between individuals

Front 15

Obj. of Tort Law: Compensation

Back 15

to indemnify (pay for) injuredperson/s.

Front 16

Cat of Tort Law: Negligent

Back 16

unintentional commission/omission of an act that a normally prudent person would or would not do under a similar circumstance. (Malpractice)

Front 17

Malpractice (Tort...negligent)

Back 17

negligence of a professional person

criminal negligence: reckless disregard

(Surgeon does surgery on wrong body part)

Front 18

Degrees of Negligence

Back 18

1. Ordinary Negligence: def. of negligence

2. gross negligence: intentional omission/commission of an act

Front 19

Elements of Negligence: Duty to Use Due Care

Back 19

is there a std. of care and was it followed?

(Duty to treat ER patient)

Front 20

Elements of Negligence: Breach of Duty

Back 20

deviation from std. of care. (employer fails to do a background check and someone gets killed)

Front 21

Elements of Negligence: Injury

Back 21

actual damages. If no injuries, no damages due.

The 4 elements of negligence must be presented in order for plaintiff to recover damages

Front 22

Elements of Negligence: Causation

Back 22

foreseeable injury from a result of commission or omission

[Failure to hydrate (std of care) leads to patient death]

Front 23

Major Categories of Tort Law

Back 23

Negligence

Intentional- always includes a willful act

Strict liability regardless of fault, intension, or negligence (product liability)

Front 24

Intentional Tort: Assault and Battery

Back 24

assault- deliberate threat coupled with apparent ability to commit battery

battery- touching another person in a socially impermissible manner w/o consent. (failure to obtain consent prior to surgery) (J-Dub blood)

Front 25

Defamation of Character

Back 25

hurting a persons character by false and malicious statements

Libel: written version

Slander: oral version

Front 26

absolute privilage

Back 26

a defense against defamation. Includes stmts made during hearings, confidential communications between spouses

Front 27

fraud

Back 27

deliberate deception to secure gain (billing, referral fees)

Front 28

strict liability

Back 28

liability without fault needing to be established. It was so wrong that it's clear.

Front 29

Res Ipsa Loquitur

Back 29

the thing speaks for itself

Front 30

crime

Back 30

social harm defined and made punishable by law

Front 31

misdemeanor

Back 31

offense punishable by less than 1 year in jail and/or a fine

Front 32

felony

Back 32

imprisonment in a state or federal prison for more than a year

Front 33

False Claims Act of 1986

Back 33

can't commit fraud:

1.Knowingly presenting a false claim for payment.

2. making a false record to get a false claim paid. 3. conspiring to defraud the government.

4. making a false record to avoid an obligation to pay or transmit property to the government.

Front 34

kickbacks

Back 34

ex. upcharging for medicare reimbursements. Government then goes in and says you should've charged this way. Give us x amount back.
Or anyone getting something for referral of patients.

Front 35

HIPPA of 1996

Back 35

provides criminal and civil enforcement tools& funding to fight health care fraud.

Program provides coordinated national framework for federal, state, & local law enforcement agencies; the private sector; & public to fight health care fraud.

Front 36

manslaughter

Back 36

Unlawful killing of another personwithout malice of forethought.

Voluntary manslaughter: intentional killing of another person (e.g., in ?the heat of passion?)Involuntary: death occurs as the result of a negligent act.

Front 37

contract

Back 37

A special agreement, written or oral, that involves legally binding obligations between two or more parties.

Front 38

Elements of a Contract. memorize word for word

Back 38

1.Offer/Communication

2.Consideration: Adequacy

3. Acceptance: Meeting of the Minds, Definite & Complete, Duration

Front 39

offer/communication

Back 39

promise by one party to do something if the other party agrees to do something.

Front 40

consideration

Back 40

each party to a contract must give up something of value in exchange for something of value.

ex. treat a patient (value) medicare pays out (value)

Front 41

meeting of the minds

Back 41

mutual assent.

Front 42

definite and complete

Back 42

details of contract clear and agree to it

Front 43

duration

Back 43

once offer accepted, any attempt to revoke the contract is too late and is invalid.

Front 44

plantiff

Back 44

person who brings a case against another in a court of law

Front 45

Independent Contractor

Back 45

is a natural person, business, or corporation that provides goods or services to another entity under terms specified in a contract or within a verbal agreement. (Phil at Intermountain). Responsible for negligent acts.

Front 46

Nonperformance defences

Back 46

a contractually obligated party does not have to perform (doing what is required by the contract) under certain laws.

ex. fraud, mistakes, duress, illegal contract, statute of limitations etc.

Front 47

demurrer

Back 47

A pleading filed by a defendant challenging legal sufficiency of a complaint.

Front 48

Examination Before Trial

Back 48

EBT may reveal sufficient facts discouragingplaintiff from continuing the case or it may encourage one or both parties to settle out of court.

Front 49

Deposition

Back 49

taken at an EBT, is the testimony of awitness that has been recorded in a written format

Front 50

Attorney-Client Privilege

Back 50

Both parties must agree that the attorney-client relationship does or will exist.

Client must seek advice from an attorney in his or her capacity as a legal advisor.

Communication between attorney & client must be identified to be confidential.

Front 51

Pretrail Conference

Back 51

Informal discussion during which the judge and the attorneys eliminate matters not in dispute, agree on the issues, and settle procedural matters relating to the trial.

(this is where a motion to dismiss a case can be put forth or summary judment)

Front 52

Summary Judgment

Back 52

Either party to a suit may believe that there are notriable issues of fact & only issues of law to be decided.In such event, either party may make a motion for summary judgment.

Front 53

Memorandum of Law

Back 53

(or trial brief ) presents tothe court the nature of the case, cites case decisions to substantiate arguments, and aids the court regarding points of law.

Front 54

Subpoena

Back 54

Subpoena ad testificandum:Subpoena for a witness

Subpoena duces tecm:Subpoena of records

Front 55

Res Ipsa Loquitur

Back 55

"the thing speaks for itself"

Legal doctrine that shifts the burden of proof fromthe plaintiff to the defendant.

Front 56

Experimenting requiruntur

Back 56

"Proof Required"

1. Event causing injury - would not normally have occurred in the absence of negligence

2. Defendant - must have exclusive control over instrument causing injury

3. Plaintiff - must not have contributed to the event causing injury.

Front 57

Awarding Damages: Nominal

Back 57

are a token in recognition that awrong has been committed. In such cases, the amount of compensation is insignificant.

Front 58

Awarding Damages: Compensatory

Back 58

intended as reparationfor detriment or injury sustained.

Front 59

Awarding Damages:Hedonic or Non-Economic:

Back 59

awarded tocompensate plaintiff for loss of enjoymentof life.

Front 60

Awarding Damages:Punitive

Back 60

additional monetary awardswhen an injury is caused by gross carelessness or disregard for others

Front 61

Joint & Several Liability

Back 61

Permits defendant to bring suit against all persons sharing responsibility for injuries.

Permits plaintiff to collect from any one? or all of defendants.

Front 62

Corporate Structures

Back 62

Executive Committee

Bylaws Committee

Finance Committee

Joint Conference Committee

Nominating Committee

Planning Committee

Patient Care Committee

etc.

Corporate Ethics...Have a code to follow

Front 63

Sarbanes-Oxley Act (SOX)

Back 63

inresponse to the Enron debacle & high profile cases of corporatemismanagement.

11 provisions.

Front 64

SOX-1

Back 64

Certification of financial reports

Ban on personal loans to exec officer & director. Accelerated reporting of trades by insiders.Prohibition on insider trades during pension fund blackout periods.

Public reporting of CEO & CFO compensation& profits.

Inside audit board independence.

Front 65

Doctrine of RespondeatSuperior

Back 65

Respondeaat Superior: 'let the master respond'

Legal doctrine holding employers liable for the wrongful acts of their employees.

Also referred to as vicarious liability, whereby an employer is answerable for the torts committed by employees

Front 66

Joint Liability

Back 66

All joint or concurrent tort-feasors (person guilty of tort) are independently at fault for their own wrongful acts.

Both hospital & its physicians can be held jointly liable for damages suffered by patients.

Front 67

Governing Responsibilities of Corporation

Back 67

CEO Selection: Administrator Licensure

Comply with the law

Comply with Standards of Accrediting BodiesProvide timely treatment

Avoid Conflicts of Interest

Front 68

Safe-Harbor Regulations

Back 68

describe how health careproviders should structure financial arrangements in order to be exempt from prosecution by the DOJ & the FTC

Front 69

Antitrust Safety Zones

Back 69

DOJ & the FTC issued policy ?statements?that address antitrust safety zones

Statements are designed to provideeducation & instruction to the health care community on issues related to mergers & joint ventures

Statements give health care providersguidance in the form of antitrust safety zones, which describe circumstances under which agencies will not challenge

Front 70

Elements of Negligence

Back 70

Duty to Use Due Care (Std. of Care)

Breach of Duty

Injury/Actual Damages

Causation (proximate cause, foreseeability)