Medical Law and Ethics Chapter 13

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Questions and Answers

What is the primary purpose of the Patient's Bill of Rights?

To regulate medical practices

To ensure patient protection and safety (correct)

To limit patient's rights

To increase healthcare costs

The Employee Retirement Income Security Act (ERISA) is one of the common laws and regulations affecting medical practices and patient care.

False

What is the purpose of the No Surprise Act?

To increase insurance premiums

To protect individuals from surprise billing (correct)

To ban emergency services

To regulate pharmaceutical pricing

HIPAA gives patients the right to their health care information.

True Signup and view all the answers

Which of the following are types of abuse? (Select all that apply)

Psychological Signup and view all the answers

Negligence in the health care setting requires a specific intent to harm someone.

False Signup and view all the answers

Which principle of ethics emphasizes doing what is best for patients, considering their pain, suffering, and quality of life?

Beneficence Signup and view all the answers

Biases can have both negative and positive consequences.

True Signup and view all the answers

Who owns the medical records in a healthcare facility?

The healthcare provider Signup and view all the answers

What type of safeguards refer to the policies and procedures documented in writing?

Administrative safeguards Signup and view all the answers

What type of consent is required when sharing health care information?

Written consent Signup and view all the answers

What type of safeguards refer to the physical monitoring and access to PHI?

Physical safeguards Signup and view all the answers

Who has the right to access a patient's medical records?

The patient's personal representatives Signup and view all the answers

What type of safeguards refer to the responsibility of the healthcare provider to monitor and safeguard patient information through technology-related items?

Technical safeguards Signup and view all the answers

Who owns the actual medical record?

The health care provider Signup and view all the answers

What is required to release medical records to another health care provider?

A signed release form from the patient Signup and view all the answers

What is an exception to releasing medical records without the patient's authorization?

A criminal act, such as evidence used in abuse cases Signup and view all the answers

Who has the right to access the patient's medical record?

The patient and their authorized representatives Signup and view all the answers

What is the purpose of a signed release form?

To protect the confidentiality of the medical record and ensure it is shared only with approved and authorized health care providers or entities Signup and view all the answers

What is the term for when the court orders someone to appear in court and bring records with them?

Subpoena duces tecum Signup and view all the answers

What is the main goal of HIPAA regarding patient information?

To give patients rights over their health care information Signup and view all the answers

Who has the right to access and control their medical records?

Patients themselves Signup and view all the answers

What is the primary purpose of the Good Samaritan Acts?

To allow bystanders to get involved in emergency situations Signup and view all the answers

What type of safeguards are implemented to protect electronic health records?

All of the above Signup and view all the answers

What law prohibits discrimination on the basis of genetic information?

GINA Signup and view all the answers

What is the primary purpose of the Patient Safety and Quality Improvement Act (PSQIA)?

To gather and analyze patient safety information Signup and view all the answers

What is the primary purpose of the Anti-Kickback Statute (AKBS)?

To prevent receiving benefits for referral or business Signup and view all the answers

What is the main purpose of training in proper documentation and maintenance of medical records?

To protect patient privacy and confidentiality Signup and view all the answers

What is the main purpose of the HIPAA Security Rule?

To implement reasonable and suitable safeguards to protect confidentiality Signup and view all the answers

Who is considered the owner of the medical records?

The healthcare provider Signup and view all the answers

What type of safeguards refer to the physical monitoring and access to PHI?

Physical safeguards Signup and view all the answers

When is written consent required under HIPAA?

When sharing health care information Signup and view all the answers

Who has the right to access a patient's medical records?

The patient Signup and view all the answers

What is the purpose of a signed release form?

To release medical records to another healthcare provider Signup and view all the answers

What right does the patient have regarding their medical records under HIPAA?

The right to access and control their medical records Signup and view all the answers

What is the purpose of a signed release form?

To ensure the confidentiality of medical records when sharing with authorized entities Signup and view all the answers

What type of safeguard is responsible for protecting patient information through technology-related items?

Technical safeguards Signup and view all the answers

Who has the right to access a patient's medical record, besides the patient?

Authorized healthcare providers Signup and view all the answers

What is an exception to releasing medical records without the patient's authorization?

When a subpoena is issued by the court Signup and view all the answers

What is the main goal of HIPAA regarding patient information?

To ensure patient confidentiality and privacy Signup and view all the answers

Who owns the medical records in a healthcare facility?

The healthcare facility Signup and view all the answers

What type of consent is required when sharing health care information?

Express consent Signup and view all the answers

What type of safeguards refer to the policies and procedures documented in writing?

Administrative safeguards Signup and view all the answers

What is required to release medical records to another health care provider?

Signed release form Signup and view all the answers

Who has the right to access a patient's medical records?

Authorized healthcare personnel and the patient Signup and view all the answers

What type of safeguards refer to the physical monitoring and access to PHI?

Physical safeguards Signup and view all the answers

What is the primary purpose of a signed release form?

To release medical records to another provider Signup and view all the answers

What is the main goal of HIPAA regarding patient information?

To protect patient information from unauthorized disclosure Signup and view all the answers

Who is considered the owner of the medical records?

The patient Signup and view all the answers

What type of consent is required when sharing health care information?

Express consent Signup and view all the answers

What type of safeguards refer to the policies and procedures documented in writing?

Administrative safeguards Signup and view all the answers

Who has the right to access a patient's medical records?

The patient and authorized healthcare providers Signup and view all the answers

What is the primary purpose of a signed release form?

To allow access to medical records Signup and view all the answers

What is the main goal of HIPAA regarding patient information?

To protect patient confidentiality and privacy Signup and view all the answers

Who has the ownership of the actual medical record?

The health care provider Signup and view all the answers

What is the purpose of a signed release form?

To ensure confidentiality and protection of medical records Signup and view all the answers

What type of safeguard is responsible for protecting patient information through technology-related items?

Technical safeguard Signup and view all the answers

Who has the right to access a patient's medical record?

The patient and authorized representatives Signup and view all the answers

What is an exception to releasing medical records without the patient's authorization?

Legally ordered subpoenas Signup and view all the answers

What is the main goal of HIPAA regarding patient information?

To protect patient privacy and confidentiality Signup and view all the answers

Who is responsible for ensuring informed consent is obtained from the patient?

Healthcare Provider Signup and view all the answers

What type of consent is implied when a patient responds to a medical assistant's question about taking their temperature?

Implied Consent Signup and view all the answers

What is the primary purpose of technical safeguards under HIPAA?

Protecting patient information through technology-related items Signup and view all the answers

Who has the right to access a patient's medical records?

Healthcare provider and authorized personnel Signup and view all the answers

What is the purpose of a signed release form?

To authorize release of medical records to others Signup and view all the answers

What type of consent is required when sharing healthcare information?

Expressed Consent Signup and view all the answers

What is the primary goal of HIPAA regarding patient information?

To protect patient information from unauthorized access Signup and view all the answers

Who owns the medical records in a healthcare facility?

The healthcare facility Signup and view all the answers

Patients have the right to control their medical records under HIPAA.

True Signup and view all the answers

The HIPAA Security Rule is primarily focused on physical safeguards.

False Signup and view all the answers

Written consent is required for all disclosures of medical records under HIPAA.

False Signup and view all the answers

Health care providers are responsible for implementing administrative safeguards to protect patient information.

True Signup and view all the answers

A signed release form is required for all disclosures of medical records.

False Signup and view all the answers

The medical provider owns the information or data found within the medical record.

False Signup and view all the answers

Only healthcare providers have access to a patient's medical records.

False Signup and view all the answers

A signed release form is required for a patient to access their own medical records.

False Signup and view all the answers

Healthcare staff can access a patient's medical record without their consent.

False Signup and view all the answers

The court can order the release of medical records with a subpoena.

True Signup and view all the answers

A patient can request the release of their medical records to anyone without a signed release form.

False Signup and view all the answers

Healthcare providers can release medical records without a patient's consent in cases of criminal acts.

True Signup and view all the answers

Medical records can be released without a patient's authorization in cases of communicable diseases.

True Signup and view all the answers

Implied consent is given through oral or written words.

False Signup and view all the answers

Informed consent ensures the patient knows and understands the treatment but does not require acceptance.

False Signup and view all the answers

HIPAA gives patients the right to access and control their medical records.

True Signup and view all the answers

Technical safeguards refer to the physical monitoring and access to PHI.

False Signup and view all the answers

A signed release form is required for release of medical records to another healthcare provider.

True Signup and view all the answers

Administrative safeguards refer to the physical monitoring and access to PHI.

False Signup and view all the answers

Medical records are owned by the healthcare facility.

True Signup and view all the answers

Study Notes

Medical Law and Ethics

Medical professionals, including medical assistants, have a primary responsibility to provide high-quality patient care and respect patient privacy and confidentiality.
They are bound by various laws and regulations and have legal and ethical responsibilities to patients, employers, and society.

Patient's Bill of Rights

The Patient's Bill of Rights was created by the American Hospital Association (AHA) in 1973 to ensure patient protection and safety.
The bill outlines 15 guarantees for patients seeking medical care, including:
- The right to be treated fairly and respectfully
- The right to receive information about diagnosis, treatment, and prognosis
- The right to make decisions about care before and during treatment
- The right to privacy and confidentiality in medical exams and records

Laws and Regulations

Patient Protection and Affordable Care Act (ACA) of 2010:
- Expands access to affordable, quality health insurance
- Emphasizes prevention and wellness
- Curbs rising health care costs
Health Insurance Portability and Accountability Act (HIPAA) of 1996:
- Gives patients rights over their health information
- Sets rules and limits on who can access patient information
Health Information Technology for Economic and Clinical Health (HITECH) Act:
- Expands on HIPAA to include provisions for electronic transmission of patient information
- Prohibits the sale of protected health information (PHI)
Other laws and regulations:
- Occupational Safety and Health (OSH) Act
- Controlled Substances Act (CSA)
- Emergency Medical Treatment and Active Labor Act (EMTALA)
- Clinical Laboratory Improvement Act (CLIA)
- Title VII of Civil Rights Act of 1964
- Americans with Disabilities Act of 1990 (ADA)
- Genetic Information Nondiscrimination Act of 2008 (GINA)
- Patient Safety and Quality Improvement Act (PSOIA)
- Anti-Kick Back Statute (AKBS)
- No Surprise Act (NSA)

Protecting Patient Privacy and Confidentiality

Legal Requirements for Maintenance, Storage, and Disposal of Records:
- HIPAA outlines patient privacy and confidentiality
- Patients have the right to receive a copy of their medical records
- Providers must adhere to HIPAA
- Employers are not considered covered entities
Sharing Information and Release of Information:
- Providers must obtain written consent before sharing patient information
- Patients have the right to access their medical records
- Exceptions to release of information include criminal acts, legally ordered disclosures, and communicable diseases

Consent is an act of reason, requiring mental capacity and possession of essential information
Types of consent:
- Implied consent: inferred based on patient actions or conduct
- Expressed consent: given orally or in writing
- Informed consent: a process ensuring the patient knows and understands the treatment and its consequences### Patient Autonomy and Consent
Patient autonomy is a critical aspect of healthcare, protecting patients' legal rights and guiding ethical healthcare practices.
Healthcare providers must obtain informed consent from patients, detailing all possible risks, benefits, and alternatives of a treatment or procedure.
Failure to obtain informed consent may lead to medical negligence and malpractice cases.

Advance Directives

Advance directives are legal documents that outline a patient's wishes for end-of-life care, such as:
- Living will: specifies medical treatments the patient wants or doesn't want, and under what conditions.
- Durable power of attorney (DPOA): appoints a healthcare agent to make medical decisions on the patient's behalf.
Advance directives are legally valid throughout the US and remain in effect until officially changed.
Healthcare providers must obtain, review, and comply with advance directives.

Do Not Resuscitate (DNR) Orders

A DNR order is a legal document that communicates a patient's wish to not receive CPR or advanced cardiac life support if their heart stops or they stop breathing.
DNR orders do not affect other treatments, such as chemotherapy, antibiotics, or dialysis.

Physician Orders for Life-Sustaining Treatment (POLST)

POLST is a type of advance directive that outlines a patient's wishes for end-of-life care, particularly for those with advanced or terminal illnesses.
POLST forms involve a shared decision-making process between the healthcare provider and patient.
POLST forms are portable, meaning they move with the patient to different healthcare providers and settings.

Legal Requirements for Reportable Violations or Incidents

Healthcare professionals are bound by laws and regulations, including criminal and civil laws, to protect patients and themselves.
Criminal law violations may result in fines, imprisonment, or capital punishment.
Civil law violations may result in civil lawsuits, with penalties including monetary damages.

Mandated Reporting

Healthcare professionals are required to report incidents of concern, such as:
- Births and deaths
- Communicable diseases
- Assaults or criminal acts
- Abuse, neglect, and exploitation
Reporting is mandatory to protect the public and vulnerable populations.

Abuse

Abuse is a misuse or maltreatment, including physical, verbal, psychological, sexual, and economic forms.
Mandated reporting laws require healthcare professionals to report suspected abuse to appropriate agencies.

Ethics and Values

Ethics are the rules, standards, and moral principles that govern a person's behavior.
Medical ethics focuses on the moral principles and judgments that healthcare professionals use to determine right and wrong in healthcare.
The basic principles of medical ethics include:
- Autonomy: respecting patients' decision-making capacity.
- Justice: ensuring fairness and consistency in healthcare.### Health Care Justice
Evaluating justice in healthcare involves considering four main areas: fair distribution of scarce resources, competing needs, rights and obligations, and potential conflicts with established legislation.
Justice is about ensuring equal treatment and fair distribution of benefits, risks, resources, and costs.

Beneficence

Beneficence is the principle of doing the "most good" or doing what is best for patients.
It involves considering patients' pain, physical and mental suffering, risk of disability and death, and quality of life.

Nonmaleficence

Nonmaleficence is the principle of "do no harm" to the patient or to the fewest number of people in society.
It is difficult to apply successfully due to the risks and adverse effects associated with most treatments.

Cultural Competence

Healthcare providers must create and deliver culturally competent patient care to meet the needs of patients from diverse backgrounds.
Cultural competence involves understanding and appreciating different cultures, establishing relationships, and building strong alliances with diverse groups.
Culture is a strong part of people's lives, influencing their views, values, humor, hopes, loyalties, and fears.

Biases

Biases can be conscious or unconscious and can negatively impact multicultural acceptance and inclusion in healthcare.
Biases can exist towards any social group, including age, sex, gender identity, physical abilities, religion, sexual orientation, and many other characteristics.
Confronting one's own biases and prejudice is a crucial step towards building multicultural competence.

Healthcare Laws and Guidelines

Various laws and guidelines regulate healthcare, including the Americans with Disabilities Act, Anti-Kickback Statute, Clinical Laboratory Improvement Act, and more.
These laws and guidelines aim to protect patients, healthcare providers, and employers from negligence, malpractice, and discrimination.

Key Terms

Advance directives: written statements of a person's wishes regarding medical treatment.
Autonomy: the capacity to think, decide, and act on one's own free will and initiative.
Durable power of attorney: a legal document naming a healthcare agent or proxy to make medical decisions for patients.
Emergency Medical Treatment and Active Labor Act: a law requiring hospitals to provide appropriate medical screening to patients seeking treatment.
Health Insurance Portability and Accountability Act: a federal law protecting sensitive patient health information from disclosure without consent.

Patient Rights and HIPAA

Patients have the right to inspect, review, and receive a copy of their medical records and billing records held by health plans and health care providers.
Patients own the information or data within the medical record, while the health care provider or facility owns the actual medical record.

Exceptions to Patient Authorization

Criminal acts: evidence used in abuse cases, stabbings, gunshot wounds, or sexual assaults
Legally ordered: court-ordered medical records submission as evidence in a court case (subpoena)

HIPAA Requirements

Covered entities (health insurance companies, clearinghouses, providers) must adhere to HIPAA
Employers are not considered covered entities
HIPAA Security Rule: implement reasonable and suitable safeguards to protect protected health information and prevent breaches of confidentiality
HIPAA requires explanation of patient rights and written consent when sharing health care information
Patients must sign a form indicating receipt of a privacy notice from a health care provider or hospital

HIPAA Safeguards

Administrative safeguards: written policies and procedures for HIPAA compliance
Physical safeguards: physical monitoring and access to protected health information (PHI)
Technical safeguards: monitoring and safeguarding patient information through technology-related items

Patient Data Ownership

Patients own the information within the medical record, but the health care provider owns the medical record
Medical records are legal documents that must remain with the health care facility

Good Samaritan Acts

Allow bystanders to get involved in emergency situations without fear of liability

Genetic Information Nondiscrimination Act of 2008 (GINA)

Prohibits discrimination on the basis of genetic information with respect to health insurance and employment

Patient Safety and Quality Improvement Act (PSOIA)

Framework for gathering and analyzing information regarding patient safety within protected health information laws

Anti-Kick Back Statute (AKBS)

Criminal law that prohibits receiving benefits for referral or business involving federal health care programs

No Surprise Act (NSA)

Protects individuals from surprise billing for emergency services from an out-of-network provider or facility without prior authorization

Patient Rights and HIPAA

Patients have the right to inspect, review, and receive a copy of their medical records and billing records held by health plans and health care providers.
Patients own the information or data within the medical record, while the health care provider or facility owns the actual medical record.

Exceptions to Patient Authorization

Criminal acts: evidence used in abuse cases, stabbings, gunshot wounds, or sexual assaults
Legally ordered: court-ordered medical records submission as evidence in a court case (subpoena)

HIPAA Requirements

Covered entities (health insurance companies, clearinghouses, providers) must adhere to HIPAA
Employers are not considered covered entities
HIPAA Security Rule: implement reasonable and suitable safeguards to protect protected health information and prevent breaches of confidentiality
HIPAA requires explanation of patient rights and written consent when sharing health care information
Patients must sign a form indicating receipt of a privacy notice from a health care provider or hospital

HIPAA Safeguards

Administrative safeguards: written policies and procedures for HIPAA compliance
Physical safeguards: physical monitoring and access to protected health information (PHI)
Technical safeguards: monitoring and safeguarding patient information through technology-related items

Patient Data Ownership

Patients own the information within the medical record, but the health care provider owns the medical record
Medical records are legal documents that must remain with the health care facility

Good Samaritan Acts

Allow bystanders to get involved in emergency situations without fear of liability

Genetic Information Nondiscrimination Act of 2008 (GINA)

Prohibits discrimination on the basis of genetic information with respect to health insurance and employment

Patient Safety and Quality Improvement Act (PSOIA)

Framework for gathering and analyzing information regarding patient safety within protected health information laws

Anti-Kick Back Statute (AKBS)

Criminal law that prohibits receiving benefits for referral or business involving federal health care programs

No Surprise Act (NSA)

Protects individuals from surprise billing for emergency services from an out-of-network provider or facility without prior authorization

Good Samaritan Acts

Allows bystanders to assist in emergency situations without fear of being sued for their actions.

Genetic Information Nondiscrimination Act (GINA)

Prohibits discrimination based on genetic information with respect to health insurance and employment.

Patient Safety and Quality Improvement Act (PSOIA)

Provides a framework for gathering and analyzing information regarding patient safety within protected health information laws.

Anti-Kick Back Statute (AKBS)

Prohibits receiving benefits for referral or business involving federal health care programs.

No Surprise Act (NSA)

Protects individuals from surprise billing for emergency services from an out-of-network provider or facility without prior authorization.

Protect Patient Privacy and Confidentiality

Legal requirements for maintenance, storage, and disposal of records are essential to protect patient privacy.

The medical record contains sensitive information regarding patient history, current health status, and planned treatment.
Patients have the right to inspect, review, and receive a copy of their medical records and billing records held by health plans and health care providers.
Only patients and authorized representatives have the right to access the patient's medical record.
The medical provider or facility owns the actual medical record, but the patient owns the information within the record.

Exceptions to Release of Medical Records

Criminal acts: evidence used in abuse cases, stabbings, gunshot wounds, or sexual assaults.
Legally ordered: court-ordered release of medical records through subpoena.
Communicable diseases: release of information required by the Centers for Disease Control and Prevention or local health departments.
Mandated examinations: ordered by employers' insurance companies for workers' compensation cases.

Consent is an act of reason, requiring sufficient mental capacity and possession of essential information.
Consent must be free of force or fraud.

Implied Consent: inferred based on signs, actions, or conduct of the patient.
Expressed Consent: given through oral or written words.
Informed Consent: ensures the patient knows, understands, and accepts the treatment that has been explained.

Good Samaritan Acts

Allows bystanders to assist in emergency situations without fear of being sued for their actions.

Genetic Information Nondiscrimination Act (GINA)

Prohibits discrimination based on genetic information with respect to health insurance and employment.

Patient Safety and Quality Improvement Act (PSOIA)

Provides a framework for gathering and analyzing information regarding patient safety within protected health information laws.

Anti-Kick Back Statute (AKBS)

Prohibits receiving benefits for referral or business involving federal health care programs.

No Surprise Act (NSA)

Protects individuals from surprise billing for emergency services from an out-of-network provider or facility without prior authorization.

Protect Patient Privacy and Confidentiality

Legal requirements for maintenance, storage, and disposal of records are essential to protect patient privacy.

The medical record contains sensitive information regarding patient history, current health status, and planned treatment.
Patients have the right to inspect, review, and receive a copy of their medical records and billing records held by health plans and health care providers.
Only patients and authorized representatives have the right to access the patient's medical record.
The medical provider or facility owns the actual medical record, but the patient owns the information within the record.

Exceptions to Release of Medical Records

Criminal acts: evidence used in abuse cases, stabbings, gunshot wounds, or sexual assaults.
Legally ordered: court-ordered release of medical records through subpoena.
Communicable diseases: release of information required by the Centers for Disease Control and Prevention or local health departments.
Mandated examinations: ordered by employers' insurance companies for workers' compensation cases.

Consent is an act of reason, requiring sufficient mental capacity and possession of essential information.
Consent must be free of force or fraud.

Implied Consent: inferred based on signs, actions, or conduct of the patient.
Expressed Consent: given through oral or written words.
Informed Consent: ensures the patient knows, understands, and accepts the treatment that has been explained.

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Description

This quiz covers the laws and regulations that healthcare professionals, including medical assistants, must follow to provide high-quality patient care and protect patient privacy.