Administrative medical assisting 5th by lindh chapter07

Chapter 7

Legal Considerations

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Sources of Law
• Constitutional law
– Constitution and 27 amendments

• Statutory law
– Laws made by states

• Common law
– “Judge-made” law

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

– Felony
• Serious crimes and serious punishments

– Misdemeanor

• Lesser crimes and lesser punishments

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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

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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
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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

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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

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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

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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

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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
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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

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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

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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

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

– Invasion of privacy

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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

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Informed Consent
• Risks if no treatment given
• Implied consent
• Consent and legal incompetence

– Emancipated minors
– Mature minors

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

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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)

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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
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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

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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

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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

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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 ()
– Electronic or telephone reporting

– Local or state health departments provide lists of
diseases and injuries

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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

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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 ()
• Durable power of attorney for health

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