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Health Law Fundamentals

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A federal statute which established national standards for electronic health care transactions.

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Health Insurance Portability and Accountability Act (HIPAA)

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A doctrine that liability insurance providers have a duty to defend their insureds even if the claim against them has no basis.

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Duty to Defend

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The process by which healthcare providers are allowed to participate in healthcare programs and accept third party payers.

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Credentialing

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Consent granted after a patient is fully informed about the procedures, risks, benefits, and alternatives.

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Informed Consent

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The rights of individuals to make decisions about their own medical care without their health care provider's influence.

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Patient Autonomy

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An advanced directive in which a person states their wishes regarding medical treatment in case they become unable to express informed consent.

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Living Will

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The right to have personal health information kept out of the public domain and to have fair, reasonable, regulated access to and usage of information.

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Privacy

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Process for resolving disputes between parties outside the courts, typically through negotiated settlements.

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Alternative Dispute Resolution (ADR)

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The permissible sharing of personal medical information by healthcare providers under specific conditions without patient consent.

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Health Information Disclosure

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Established standards and practices that organizations are expected to follow to protect electronic health records and other information.

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Healthcare Compliance

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The body of law that deals with regulating the manufacture, distribution, and marketing of drugs and medical devices.

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Food and Drug Law

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Information about a patient's health status or treatment that identifies the individual or for which there is a reasonable basis to believe can be used to identify the individual.

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Protected Health Information (PHI)

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A method of payment by which healthcare providers are paid a fixed amount per enrollee to cover a defined scope of services, regardless of actual services provided.

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Capitation

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Negligent or improper treatment by medical professionals leading to harm or injury of a patient.

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Medical Malpractice

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A wrongful act or an infringement of a right (other than under contract) leading to civil legal liability.

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Tort

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An agreement between parties to settle a dispute beforehand by establishing the amount of compensation in case of loss.

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Release of Liability

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An obligation of healthcare providers to harm not their patients. The avoidance of causing harm.

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Nonmaleficence

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The legal obligation of health care professionals to keep a patient's personal health information private.

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Confidentiality

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Safeguards to protect sensitive data, ensuring that only authorized users can access certain information.

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Health Data Security

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A legal document that designates another person to make healthcare decisions if one is unable.

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Healthcare Power of Attorney

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Unsolicited intervention by third parties to protect or promote health but potentially against the individuals' will.

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Paternalism

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A legal agreement between a patient and medical provider regarding the health care services provided.

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Healthcare Contract

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The financial responsibility for damages or loss shared among individuals or entities.

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Joint and Several Liability

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Federal law that prohibits employers from discriminating against employees or applicants because of genetic information.

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Genetic Information Nondiscrimination Act (GINA)

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A government-funded social insurance program providing health insurance to people aged 65 and over or to those who meet other special criteria.

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Medicare

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A state-provided insurance program for low-income individuals and families.

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Medicaid

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Legal standards and principles applied to healthcare providers, insurers, and patients.

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Health Law

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A set of instructions creating obligations to the patient, common among healthcare professionals.

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Standard of Care

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Federal law providing employees and their families the right to temporary continuation of health coverage at group rates.

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Consolidated Omnibus Budget Reconciliation Act (COBRA)

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The unlawful practice of manipulating a patient's personal injury claim for financial gain.

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Healthcare Fraud

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