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Administrative medical assisting 5th by lindh chapter07

Chapter 7

Legal Considerations

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or duplicated, or posted to a publicly accessible website, in whole or in part.


Sources of Law
• Constitutional law
– Constitution and 27 amendments

• Statutory law
– Laws made by states

• Common law
– “Judge-made” law

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.



Sources of Law
• Criminal law
– Malfeasance
• Illegal conduct by an official

– Felony
• Serious crimes and serious punishments

– Misdemeanor
• Lesser crimes and lesser punishments

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Sources of Law
• Civil law
– Misfeasance
• Lawful act improperly or unlawfully executed

– Nonfeasance
• Failure to perform an act, official duty, legal requirement

– In a civil case, a plaintiff brings charges against a
defendant
– Common forms of civil law are administrative,
contract, and tort law

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Administrative Law
• IRS
• Medicare/Medicaid
• Title VII of the Civil Rights Act of 1964
– Protects employees from discrimination
– Harassment


• Equal Pay Act (EPA) of 1963
• Federal Age Discrimination in
Employment Act of 1967
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Administrative Law
• Americans with Disabilities Act (ADA) of
1990
– Title I prohibits discrimination in employment
– Titles II–IV mandate access to public services by
individuals with disabilities

• Family and Medical Leave Act (FMLA)
of 1993

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Administrative Law
• Health Insurance Portability and
Accountability Act (HIPAA) of 1996
– Requires national standards for electronic health
care transactions
– Assists in making health insurance more
affordable and accessible when people change or
lose their jobs
– Identified in Titles I–VII

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Administrative Law
• Occupational Safety and Health Act
(OSHA) of 1967
• Controlled Substances Act of 1970
– Five schedules (I, II, III, IV, V) according to
potential for abuse and dependence

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Administrative Law
• Uniform Anatomical Gift Act of 1968
• Regulation Z of the Consumer
Protection Act of 1967 (Truth in Lending
Act)
• Medical Practice Acts

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Contract Law
• Expressed contracts
– Written or verbal

• Implied contracts
– Indicated by actions
– Majority of provider–patient contracts

• Contract to be valid and binding, parties
who enter into it must be competent
• MAs considered agents of their
employers
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Contract Law
• Termination of contracts
– Patient discharges provider
– Provider formally withdraws from patient care
– Treatment no longer needed by patient

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Tort Law
• Wrongful act other than a breach of
contract
• Standard of Care and Scope of Practice
– Four Ds of negligence
• Duty of care
• Derelict: breach of duty of care
• Direct cause: legally recognizable injury occurs as a
result of the breach of duty of care
• Damage: wrongful activity must have caused injury or
harm that occurred

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Tort Law
• Standard of Care and Scope of Practice
– Medical Assistant’s role in negligence






Practice within scope of one’s instruction and education
Each state is likely different
Torts are intentional or negligent
Intentional torts deliberate acts violating another’s rights
Negligent torts not deliberate; result of omission or
commission of an act
• Res ipsa loquitur and respondeat superior

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Tort Law
• Common torts
– Battery: unprivileged touching of one person by
another
– Defamation of character
• Libel
• Slander

– Invasion of privacy

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Informed Consent
• Nature of any procedure and how it is
performed
• Possible risks as well as expected
outcomes of any procedure
• Any other methods of treatment and
those risks

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Informed Consent
• Risks if no treatment given
• Implied consent
• Consent and legal incompetence
– Emancipated minors
– Mature minors

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Risk Management
• Practicing good risk management
makes MA and provider less vulnerable
to litigation
• Avoid incidents that may lead to
litigation

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Risk Management
• Professional liability coverage
– Cover costs of litigation that may occur
– Health care employees need their own
professional liability coverage
– MAs can purchase from American Association of
Medical Assistants (AAMA)

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Civil Litigation Process
• Subpoenas
– Court order naming date, time, reason to appear
– Portion or entire medical record may be
subpoenaed
– Health care provider (subpoena duces tecum) may
be subpoenaed to testify
– For courts to have access to some records, a
court order required in many states
– HIPAA law requires clinics to identify what
information they will release regarding patients
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Civil Litigation Process
• Discovery
– Interrogatory
– Deposition
– Expert witness

• Pretrial conference
– Alternative dispute resolution (ADR)
• Mediation
• Arbitration

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Civil Litigation Process
• Trial
– Held before a judge
– Held before judge and a jury
– If plaintiff’s case successful, judge or jury may
award specific amount of money or damages
– If defendant’s case successful, case is dismissed

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Statutes of Limitations
• Begin at time negligent act was
committed
• When act discovered
• When care of patient and provider–
patient relationship ended
• Time limit for individuals to initiate legal
action

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Public Duties
• Reportable diseases/injuries
– “Nationally Notifiable Infectious Diseases” listed on
CDC’s Web site (http://www.cdc.gov)
– Electronic or telephone reporting
– Local or state health departments provide lists of
diseases and injuries

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Public Duties
• Abuse
– Child abuse
– Elder abuse
– Intimate partner violence (IPV)

• Good Samaritan laws
– Encourage health care professionals to provide
medical care within scope of training without fear
of being sued for negligence

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Advance Directives
• Physician Orders for Life-Sustaining
Treatment (POLST)
• Living wills, advance directives, health
care proxy
• Samples available at U.S. Legal Forms
Web site (http://USlegalforms.com)
• Durable power of attorney for health
care
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


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