Legal and Regulatory Issues
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each of the black spaces below before clicking
on it to display the answer.
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| Statutory Law | Laws passed by legislative bodies
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| Case Law (Common Law) | Based on court decisions that establish a precedent
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| Precedent | Standard/common law
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| Civil Law | Deals with all areas of the law that are not classified as criminal.( dogs barking)
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| Criminal Law | Public law that defines crimes and their prosecution. Property damage
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| Subpoena | Order of the court that requires a witness to appear at a particular time and place to testify.
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| Subpoena Duces Tecum | ordered by a judge to bring a patient's medical record to court hearing
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| Deposition | Testimony under oath taken outside of court
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| Interrogatory | a list of questions that must be answered in writing.
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| Qui Tam | private citzens to file a lawsuit in the name of the government
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| Record Retention | Storage of documentation for an established period of time
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| Fraud | An intentional deception or misrepresentation that someone makes
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| Abuse | Involves actions that are inconsistent with accepted
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| Privileged Communication | Any information communicated by patient to a healthcare provider
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| Protected Health Information (PHI) | Information that is identifiable to an individual such as name
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| Privacy | Right of individuals to keep their information from being disclosed to others
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| Confidentiality | Involves restricting patient information access to those with proper authorization and maintaining the security of patient information
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| Security | Safekeeping of patient information
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| overpayments | receives in excess of amounts due and payable under Medicare and Medicaid statues and regulations.
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| authorization | official permission or approval prior to disclosing the individuals information
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| Medicare Conditions of Participation | the retention of patient records in their original or legally reproduced form for a period of at least 5 years (CA 7-10 )
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| Department of Health and Human Services Office to the Inspector General | prepares the case for referral to the Department of Justice for criminal and or civil prosecution. A person guilty of Medicare fraud faces criminal
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| HIPAA - Health Insurance Portability and Accounting Act 1996 | improves the portability and continuity of health insurance
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| HIPAA title I Health Care Access | Portability and Renewability
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| HIPAA title II | Preventing Health Care Fraud and Abuse
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| medically necessary | providing the reasons why treatment is medically necessarey
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| ARRA | protects whistle blowers
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| What special handling is required to release medical information for a patient who is HIV- positive | the patient should sign an additional authorization statement for release of information
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