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CPHRM Legal/Reg

CPHRM Legal and Regulatory 2014

Statutory law enacted by congress and approved by the president (PSQA, EMTALA, COP)
Administrative law Regulations and rules developed and implemented by a federal or state agency to provide direction for carrying out the purposes of the Acts it oversees (how to implement EMTALA, COP)
Patient Self-Determination Act provide written info to all adult patients on admission; comply with state law regarding pt rights; document in MR; do not condition the provision of care on execution of advance directive; educate staff and community
Types of Advance Directives Living Wills and Power of Attorney
Advance Directives vs. DNR Advance Directives come from patient vs. DNR is physician’s order
Rescinding of DNR orders may be rescinded for surgical interventions
Capacity normally determined by physician; patient must be able to understand the nature of the situation and the consequences of the decision and are able to communicate the wishes to the caregiver
Outcome of Quinlan Case established ethics committee and led to creation of advanced directives
Outcome of Cruzan Case Developed Patient Self Determination Act
Outcome of Stamford Case Theory of “battery” resulted
Outcome of Schlinder Case Withdrawal of life support; Support of patient’s wishes
Ethics Committee decisions nonbinding; consultative only
Informed consent basic elements disclosure of nature and purpose; probable risks and benefits; risks and benefits of alternatives; risks and benefits of foregoing; opportunity for questions and understandable answers; opportunity to make decision free of coercion and undue influence
Battery vs Negligent Consent battery is intentional and does not require proof of harm; negligent consent is unintentional that requires injury
CoP provides minimum health and safety standards providers must meet for Medicare and Medicaid certification
CoP Nursing Mandated reporting reporting blood transfusion reactions, adverse drug reactions, and medication errors
HACs CMS Hospital Acquired Conditions: retained objects; air embolism; blood incompatibility; stage III and IV Pressure Ulcers; Falls and Trauma: Iatrogenic Pndumothorax; poor glycemic control; CAUTI; Vascular Catheter-Associated Infection; SSI; DVTl/PE
HCQIA Health Care Quality Improvement Act: National Practitioner Data Bank provides conditional immunity from anti-trust suits against healthcare facilities and their medical staff that participate in peer review
NPDB reporting requirements report payments of judgments or settlements within 30 days; actions taken which adversely affect privileges of physicians report within 15 days; disciplinary actions report within 30 days
HIPDB Healthcare Integrity and Protection Data Bank: clearinghouse for the reporting and disclosure of certain final “adverse actions” taken against health care practitioners, suppliers, and other providers in an effort to combat fraud and abuse
Hospital Value-Based Purchasing Program domains Clinical Process of Care; Patient Experience of Care; Outcome
Hospital Value-Based Purchasing Program Quality incentive program built on the Hospital Inpatient Quality Reporting (IQR) measure reporting infrastructure
SMDA Safe Medical Device Act: Gathers information regarding safety of medical devices, including reports about adverse incidents associated with their use (including user error)
SMDA required to report vs. exempt Reports: Hospitals, ambulatory surgical centers, outpatient diagositc, nursing homes, home care agencies, ambulance providers, rehab/psych facilities; Exempt: Physicians’ offices, etc
SMDA what and when to report Death to manufacturer and FDA within 10 days; serious injury to manufacturer (or FDA if manufacturer is unknown) within 10 working days; eMDR summary no later than January 1st
EMC Emergency Medical Condition (under EMTALA) which includes psychiatric illness, including alcohol and drug intoxication
Criteria for discharging unstable patient patient refuses treatment or requests transfer; hospital does not have capability; physician certifies that benefits of transfer outweigh the risks
EMTALA Mandatory Reporting required to report suspected improper transfers within 72 hours
EMTALA Sanctions termination of the hospital’s Medicare provider agreement or civil monetary penalties of up to 50K per violation
LTC Laws Long Term Care Laws: requirements that an institution must meet in order to qualify to participate as a SNF (skilled nursing facility) in the Medicare program, and as a nursing facility in the Medicaid program
Child Abuse and Elder/Dependent Abuse Reporting Laws need process in place to define who is allowed to do reporting
ADA Title III Nondiscrimination on the Basis of Disability in Public Accommodations and Commercial Facilities
ADA definition of disability a physical or mental impairment that substantially limits one or more of the major life activities of such individual
HITECH Health Information Technology for Economic and Clinical Health Act: promotes and advances the adoption of health information technology (HIT)
HITECH Breach Notification timeframe within 60 days notify individual, post on home page, imminent misuse notice by telephone, written notice, if over 500 residents must provide to prominent media
Omnibus Budget Reconciliation Act Stark I, II, III – Anti self-referral law; deters fraud by prohibiting a physician from referring patients to an entity if the physician or a member of his immediate family has a financial relationship with the entity
RAC Recovery Audit Program: to identify and correct Medicare improper payments through the detection and collection of overpayments and underpayments made on claims of health care services provided to Medicare beneficiaries
MMSEA requires that liability insurers (including self-insurers), no-fault insurers, and workers’ compensation plans report specific information about Medicare beneficiaries
Created by: Camellia Acker Camellia Acker