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Terms in this set [35]
Sherman Act:
Healthcare facilities may also have an agreement on ------ which occurs when one or more health organizations decide which type of services will be offered at each organization.
market division
refers to healthcare providers that will only sell a product to a consumer who will also buy a second product from them.
tying
When healthcare providers have an agreement to not deal with anyone outside their group, that is considered interfering with the consumers' rights to choose.
boycotts
Places
restrictions on hospital mergers and acquisitions
Allows individuals to sue for three times their actual damages plus legal costs
act?
clayton act
ensures those hospitals and other entities that entered mergers, acquisitions, and joint ventures must notify DOJ and FTC before any final decisions are made.
act?
Clayton act
The concept of informed consent is based on the patient's right to make an informed decision regarding medical treatment. It is a legal requirement in all 50 states. The provider is responsible for discussing with the patient:
3
The diagnosis if it has been established;
The nature of a proposed treatment or operation, including the risks and benefits, any alternatives, and the risks and benefits of the alternatives;
And the risks and benefits of not agreeing to the procedure or treatment.
If a patient did not provide informed consent for a procedure or treatment, it is considered a case of
negligence
To determine what constitutes informed consent, there are two legal standards that are applied
reasonable patient standard [more in use]
reasonable physician standard
requires hospitals, nursing homes, home health providers, hospices, and managed care organizations that provide services to Medicare- and Medicaid-eligible patients to supply information on patient rights to patients upon admission.
It virtually applies to every type of healthcare facility.
The Patient Self-Determination Act of 1990
The facility must provide adult patients with written information, under the state law, about making healthcare decisions.
what?
patient bill of rights
Based on the concept of informed consent, in 1972 the Board of Trustees of the American Hospital Association developed a
patient bill of rights
------- states that the patient has the
right to all information from this provider regarding any testing, diagnoses, and treatments.
This information must be provided to the patient in terms that the patient will be able to understand.
patient bill of rights
imposes criminal penalties on anyone who tries to present fictitious claims for payment to the federal government.
false claims act of 1995
It is one of the most powerful government tools to combat civil fraud in health care.
This act provides financial incentives for whistleblowers—allowing employees to blow the whistle about contractor fraud against the federal government.
false claims act of 1995
As a result of the financial incentive program, the federal government has received $--- billion in returned funds.
12 billion
prohibits physicians, including dentists and chiropractors, from referring Medicare and Medicaid patients to other providers to services in which they have a financial interest.
Ethics in Patient Referral Act of 1989
This landmark act prohibits discrimination based on race, sex, color, religion, and national origin. Sexual harassment issues falls under this Act.
Civil Rights Act of 1964, Title VII
Civil rights act of 1991, title VII did?
only allowed damages for back pay. This act enables individuals to receive both punitive damages, which are damages that punish and defendant and compensatory damages for financial or psychological harm.
PUNITIVE AND COMPENSATORY DAMAGES
This act protects employees and job applicants 40 years and older from discrimination as it applies to hiring, firing, promotion, layoffs, training, assignments, and benefits
Age Discrimination in Employment Act of 1967
This act amended the Age Discrimination in Employment Act. Its goal was to ensure that older workers' employee benefits were protected and that organizations provide the same benefits to both younger and older workers
Older Workers Benefit Protection Act of 1990
This act, amended the Fair Labor Standards Act, enforced by the U.S. Department of Labor, mandates that all employers award pay fairly to both genders if it is determined their jobs have equal responsibilities and require the same skills
equal pay act of 1963
is an amendment to Title VII of the Civil Rights Act of 1964. This act protects female employees who are discriminated against based on pregnancy-related conditions, which constitutes illegal sex discrimination
the pregnancy discrimination act of 1978
focuses on individuals who are considered disabled in the workplace.
---- states that employment discrimination is
prohibited against individuals with disabilities who can perform essential functions of a job with or without reasonable accommodation
Americans with Disabilities act of 1990, ADA
are job duties that must be performed to be a satisfactory employee
essential functions
refers to employers that take reasonable action to accommodate a disabled individual such as providing special computer equipment or furniture to accommodate a physical limitation.
reasonable accommodation
Occupational Safety and Health Act of 1970: This law was passed to ensure that employers have a ---------,
which is very important for the healthcare industry because of potential exposure to bacteria, viruses, and contaminated fluids.
general duty to provide a safe and healthy work environment for their employees
regulates pension and benefit plans for employees, including medical and disability benefits.
It protects employees because it forbids employers from firing an employee so that they cannot collect under their medical coverage.
The Employee Retirement Income Security Act of 1974 [ERISA]
an
amendment to ERISA, was passed to protect employees who lost or changed employers so they could keep their health insurance if they paid 102% of the full premium.
The act was passed because, at the time, people were afraid to change jobs, resulting in the concept of job lock.
Consolidate Omnibus Budget Reconciliation Act of 1986 [COBRA
passed to stop job lock
Consolidate Omnibus Budget Reconciliation Act of 1986 [COBRA]
was passed to promote patient information and confidentiality in a secure environment.
Fully implemented in 2003, the amount of health information released is controlled by the consumer. This is the first federal legislation that provides in-depth protection of consumer's health information.
Health Insurance Portability and Affordability Act of 1996 [HIPAA]
: Effective September 23, 2009, this act amends HIPAA by requiring stricter notification protocols for breach of any patient information
Health Information Technology for Economic and Clinical Health Act of 2009
requires employers with 50 or more employees within a 75-mile radius who work more than 25 hours per week and who have been employed more than 1 year to provide up to 12 work weeks of unpaid leave, during any 12-month period, to provide care for a family member or the employee him or herself.
Family Medical Leave Act of 1993 [FMLA]
prohibits U.S. insurance companies and employers from discriminating based on information derived from genetic tests.
Specifically, it forbids insurance companies from discriminating through reduced coverage or price
increases. It also prohibits employers from making adverse employment decisions based on a person's genetic code.
Genetic Information Nondiscrimination Act of 2008
an amendment to Title VII of the Civil Rights Act of 1964, which also applies to claims under the Age Discrimination Act of 1967 and the Americans with Disabilities Act of 1990, provides protection for unlawful employment practices related to compensation discrimination.
Lilly Ledbetter Fair Pay Act of 2009 [FPA]
Steps for nondiscriminatory actions in the work place
To help protect employers from being accused of unfair employment practices. The following summarizes the steps of the program
Establish compensation criteria
Develop pay audits and document these audits for several years
Document retention processes related to pay
Train managers on providing objective performance evaluations
Develop and implement a rigorous statistical analysis of pay distributions
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