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Fundamentals of Health Care Law

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Affordable Care Act (ACA)

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The Affordable Care Act, also known as Obamacare, is a comprehensive health care reform law enacted in March 2010. It aims to make health insurance more affordable and accessible, and to reduce the costs of health care for individuals and the government.

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Medicaid

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Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, like nursing home care and personal care services.

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Anti-Kickback Statute

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The Anti-Kickback Statute is a federal law that prohibits the exchange of anything of value in an effort to induce or reward the referral of federal health care program business.

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HIPAA

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The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that mandates the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge.

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Certificate of Need (CON)

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A Certificate of Need is a legal document required in some states before proposing the construction of new healthcare facilities. Its purpose is to prevent the overexpansion of health care services and promote cost containment.

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Risk Management

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Risk Management in health care involves the identification, assessment, and prioritization of risks followed by coordinated efforts to minimize, monitor, and control the probability and/or impact of unfortunate events or to maximize the realization of opportunities.

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Advanced Directive

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An Advanced Directive is a legal document in which an individual specifies what actions should be taken for their health if they are no longer able to make decisions because of illness or incapacity.

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False Claims Act

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The False Claims Act allows individuals to sue on behalf of the government for false claims made for government funds. In health care, it's often applied to cases of fraud or misuse of Medicare or Medicaid funds.

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Stark Law

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The Stark Law prohibits physician self-referral, especially when a physician refers a patient to a medical facility in which he or she has a financial interest, for certain designated health services paid by Medicare or Medicaid.

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Consent

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In health care law, consent refers to the agreement by a patient to undergo a medical procedure or treatment after being informed of and understanding the risks, benefits, and alternatives.

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Health Care Proxy

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A health care proxy is a legal document that allows an individual to appoint someone else to make medical decisions on their behalf if they become incapable of making those decisions themselves.

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EMTALA

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The Emergency Medical Treatment and Active Labor Act (EMTALA) is a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay.

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Medicare

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Medicare is a federal health insurance program primarily for individuals who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease.

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Health Care Power of Attorney

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Health Care Power of Attorney is a legal document that designates an individual to make health care decisions on another person's behalf in the event that they become unable to do so.

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