| Term Definition unexplained/unexpected death, development of pressure sores, heavy medication and sedation, malnourished, hesitation to talk openlyTerm Definition any form of mistreatment that results harm or loss to an older personTerm Definition Most states have enacted laws that require the reporting of actual or suspected cases of communicable diseasesTerm National Practitioner Data BankDefinition created by Congress as a national repository of information with the primary purpose of facilitating a comprehensive review of physician's and other health care practitioners' professional credentialsTerm Health Care Quality Improvement ActDefinition Congress enacted the HCQIA of 1986 to improve the quality of medical care by encouraging physicians to participate in peer review and by restricting incompetent physician’s ability to move from state to state without disclosure or discovery of their previous substandard performance or unprofessional conductTerm Definition incident reports contain statements made by employees and physicians regarding a deviation from acceptable patient care; reportable incidents include serious injury, fire, loss of emergency power, employee strikes, infection outbreaks; don’t go in patient’s recordTerm Definition data bank queries can be made by state licensing boards, hospitals, other health care entities, and professional societies that have entered or may be entering employment or affiliation relationships with a physician, dentist, or other health care practitioner who has applied for clinical privileges or appointment to a medical staffTerm Employee Refusal to Participate in AbortionsDefinition individuals have a right to refuse to participate in abortions and can abstain from involvement in abortions as a matter of conscience or religious or moral convictionTerm Definition the termination of the ability to produce offspring. Sterilization often is accomplished by vasectomy for men and tubal ligation for womenTerm Wrongful Conception/PregnancyDefinition based on damages sustained by the parents of an unexpected child based on an allegation that conception of the child is the result; ex. negligent sterilization procedureTerm Definition the plaintiffs claim that but for a breach of duty by the defendants (ex. improper sterilization), the child would not have been born. A wrongful birth claim can be brought by the parents of a child born with genetic defects against a physician or laboratory; based on the premise that being born, and that negligently fails to inform them; being born and having to live with the affliction is a disadvantage and thus a cognizable injuryTerm Definition generally unsuccessful because of the court’s unwillingness, for public policy reasons, to permit financial recovery for the injury of being born into the worldTerm Definition direct contact with infected blood/body fluids, such as vaginal secretion and breast milkTerm Duty and the right to confidentialityDefinition health care professionals and others working with AIDs patients have a right to know when they are caring of patients with highly contagious diseasesTerm Definition U.S. district court found that routine testing of firefighters and paramedics for the AIDS virus does not violate an individual’s fourth amendment or constitutional privacy rightsTerm Definition against person who have contracted the AIDs virus often is found to be in violation of their constitutional rightsTerm Occupational Safety and Health ActDefinition requires that health care organizations implement strict procedures to protect employees against the virus that causes AIDSTerm Definition 1) set of rules/conduct/moral code 2) religious ethics 3) philosophical ethicsTerm The functions of Ethics CommitteesDefinition multifaceted and include development of policy and procedure guidelines to assist in resolving ethical dilemmas; staff and community education; conflict resolution; case reviews, support and consultation, and political advocacyTerm Patient Self Determination ActDefinition requires health care organizations to explain to patients their legal right to direct their own medical and nursing care as it corresponds to existing state law o Euthanasia- the mercy killing of the hopelessly ill, injured, or incapacitatedTerm Oregon’s Death with Dignity Act of 1994Definition allows physicians to prescribe but not administer lethal drugs to the requester who must be terminally ill with fewer than 6 months to liveTerm Definition a risk is the possibility that a loss will occur. An insured individual may be exposed to 3 categories of risk- 1) property loss/damage 2) personal injury or loss of life 3) incurring legal liabilityTerm Definition the period of the policy is sated in the insurance contract. Under the occurrence policy, the contract provides protection only for claims that occur during the time frame within which the policy is stated to be in effectTerm Definition trustees should be covered by liability insurance just as physicians and other health care professionalsTerm Definition Although federal laws generally take precedence over state laws when there is a conflict between state and the federal laws, state laws are applicable and must be considered, especially when state regulations are more rigid than federal legislationTerm Definition The U.S. Department of Labor is a department within the executive branch of governmentTerm National Labor Relations ActDefinition enacted by congress in July 1935 to govern the labor management relations of business firms engaged in interstate commerceTerm National Labor Relations BoardDefinition entrusted with enforcing and administering the NLRA, has jurisdiction over matters involving proprietary and not for profit health care organizationsTerm Definition aimed at reducing the number of injunctions grated to restrain strikes and picketingTerm Definition The federal antidiscrimination law provides that is unlawful for most public and private employers to discriminate against, fail or refuse to hire, or discharge any individual, with respect to his or her compensation, terms, conditions, or privileges of employment because of such individual’s race, color, religion, sex, or national originTerm Definition osha’s mission is to assure the safety and health of America’s workers by setting and enforcing standards, providing training, outreach and educational establishing partnerships, and encouraging continual improvement in workplace safety and healthTerm Family and Medical Leave Act of 1993Definition was enacted to grant temporary medical leave toe employees under certain circumstancesTerm Duty and the right to confidentialityDefinition health care professionals and others working with AIDs patients have a right to know when they are caring of patients with highly contagious diseasesTerm Definition U.S. district court found that routine testing of firefighters and paramedics for the AIDS virus does not violate an individual’s fourth amendment or constitutional privacy rightsTerm Definition against person who have contracted the AIDs virus often is found to be in violation of their constitutional rightsTerm Occupational Safety and Health ActDefinition requires that health care organizations implement strict procedures to protect employees against the virus that causes AIDSTerm Definition 1) set of rules/conduct/moral code 2) religious ethics 3) philosophical ethicsTerm The functions of Ethics CommitteesDefinition multifaceted and include development of policy and procedure guidelines to assist in resolving ethical dilemmas; staff and community education; conflict resolution; case reviews, support and consultation, and political advocacyTerm Patient Self Determination ActDefinition requires health care organizations to explain to patients their legal right to direct their own medical and nursing care as it corresponds to existing state law o Euthanasia- the mercy killing of the hopelessly ill, injured, or incapacitatedTerm Oregon’s Death with Dignity Act of 1994Definition allows physicians to prescribe but not administer lethal drugs to the requester who must be terminally ill with fewer than 6 months to liveTerm Definition a risk is the possibility that a loss will occur. An insured individual may be exposed to 3 categories of risk- 1) property loss/damage 2) personal injury or loss of life 3) incurring legal liabilityTerm Definition the period of the policy is sated in the insurance contract. Under the occurrence policy, the contract provides protection only for claims that occur during the time frame within which the policy is stated to be in effectTerm Definition trustees should be covered by liability insurance just as physicians and other health care professionalsTerm Definition Although federal laws generally take precedence over state laws when there is a conflict between state and the federal laws, state laws are applicable and must be considered, especially when state regulations are more rigid than federal legislationTerm Definition The U.S. Department of Labor is a department within the executive branch of governmentTerm National Labor Relations ActDefinition enacted by congress in July 1935 to govern the labor management relations of business firms engaged in interstate commerceTerm National Labor Relations BoardDefinition entrusted with enforcing and administering the NLRA, has jurisdiction over matters involving proprietary and not for profit health care organizationsTerm Definition aimed at reducing the number of injunctions grated to restrain strikes and picketingTerm Definition The federal antidiscrimination law provides that is unlawful for most public and private employers to discriminate against, fail or refuse to hire, or discharge any individual, with respect to his or her compensation, terms, conditions, or privileges of employment because of such individual’s race, color, religion, sex, or national originTerm Definition osha’s mission is to assure the safety and health of America’s workers by setting and enforcing standards, providing training, outreach and educational establishing partnerships, and encouraging continual improvement in workplace safety and healthTerm Family and Medical Leave Act of 1993Definition was enacted to grant temporary medical leave toe employees under certain circumstancesTerm Family and Medical Leave Act of 1993Definition Was enacted to grant temporary medical leave to employees under certain circumstancesTerm Union Security Contracts and Right to Work LawsDefinition labor organizations frequently seek to enter union security contracts with employers; 1) the closed shop contract 2) the union shop contractTerm Definition is a program by which an employee can receive certain wage benefits because of work related injuriesTerm Patient's rights during Labor DisputesDefinition patient’s rights take precedence over employee and management rights when a patient’s right to privacy or well-being is in jeopardy due to labor disputesTerm Definition the ADA prohibits job discrimination in hiring against qualified individuals with disabilities by private employers, state, and local governments, employment agencies, and labor unionsTerm Definition unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature when this conduct explicitly or implicitly affects and individual’s employmentTerm Definition the tendency to form some possible in positions of power to abuse that power through threats, abuse, intimidation, and retaliatory discharge, all of which are cause for legal actionTerm Definition a termination for cause only clause in an employment contract is bindingTerm Definition the denial of a right that is imputed to a person or that is alleged to belong to him or herTerm Managed Care OrganizationsDefinition o Managed care organizations represent a major shift away from the domination of the fee for service system toward networks of providers supplying a full range of servicesTerm Definition The California Supreme Court has ruled that insurers must inform beneficiaries of their right to contest a benefit denial.Term Maricopa County Medical Society v. Arizona UniversityDefinition o One of the leading cases involving price fixing is Maricopa County Medical Society v. Arizona University, a US Supreme Court case that involved the exercise of provider control over the level of physician reimbursement. Because the physicians had no financial stake in the success of the plan, the Supreme Court found that the maximum fee schedule set by the physicians constituted illegal price fixingTerm Definition is the process by which parties to dispute voluntarily agree to submit their differences to the judgment of an impartial mediation panel for resolutionTerm Definition the process whereby a third party, the mediator, attempts to bring about a settlement between the parties of a complaintTerm Joint and Several LiabilityDefinition provides that a person causing an injury concurrently with another person can be held equally liable for the entire judgment awarded by a courtTerm Definition compensates injured parties for economic losses regardless of faultTerm Definition the possibility that a loss will occurTerm Health Maintenance Organizations (HMO's)Definition organized health care systems that are responsible for both the financing and the delivery of a broad range of comprehensive health services to an enrolled population. Act as both an insurer and provider of health care servicesTerm Preferred Provider Organizations (PPO's)Definition entities through which employer health benefit plans and health care services contract to purchase health care services for covered beneficiaries from a selected group of participating providersTerm Exclusive Provider Organizations (EPO's)Definition Limit their beneficiaries to participating providers for any health care services. Use a gatekeeper approach to authorize nonprimary care servicesTerm Point of Service Plans (POS)Definition use primary care physicians as gatekeepers to coordinate and control medical careTerm Definition provided limited components of healthcare coverage (ex. dental)Term Independent Practice Associations (IPA)Definition a legal entity composed of physicians organized for the purpose of negotiating contracts to provide physician servicesTerm Definition A physician group that has only one or a small number of service delivery locations is a group practiceTerm Definition The California Supreme Court has ruled that insurers must inform beneficiaries of their right to contest a benefit denial |
