30 Key Health Law Topics: Answers for Professionals and Patients

Patient Rights

What is HIPAA, and how does it protect patients?

HIPAA protects patient health information, keeping it confidential, controlling data sharing, and providing rights to access records.

What are patients’ rights under EMTALA?

The Emergency Medical Treatment and Labor Act requires hospitals to provide emergency care regardless of the patient’s ability to pay.

Can patients refuse medical treatment?

Yes, competent adults have the right to refuse treatment, even though it could be fatal, except as ordered by the courts in specific circumstances.

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What is informed consent?

Informed consent occurs when patients have full information concerning a treatment’s risks, benefits, and alternative treatments before they voluntarily give consent to treatment.

What is a patient’s right to access medical records?

Patients may inspect and copy their medical record, and provider shall comply within 30 days after receiving such request under HIPAA.

Provider Responsibilities

Standard of care

The degree of care that, in light of current medical practice, a reasonably competent practitioner would have exercised under similar circumstances.

What is medical malpractice?

Malpractice results when a patient is harmed by a healthcare provider’s negligence due to misdiagnosis or inappropriate treatment

Healthcare providers’ obligations under HIPAA

Providers should protect confidentiality, allow for data sharing appropriately, and report breaches of Protected Health Information (PHI).

What is the duty to warn?

Providers may be required to violate confidentiality to alert individuals or authorities of a patient’s potential danger to themselves or others.

What are advance directives, and how must providers handle them?

Living wills and DNR orders are documents that direct end-of-life care, and providers are statutorily required to comply with them.

Health Insurance and Billing

What rights does the Affordable Care Act (ACA) afford?

The ACA banned pre-existing condition exclusions, required essential health benefits, and expanded dependent coverage for young adults under their parents’ plans.

What is balance billing?

Tells patients the charge for care delivered minus what their insurance will pay, and it is in a great many states prohibited by law and federal regulation.

What are surprise medical bills?

Surprise bills from out-of-network care are covered under the No Surprises Act, limiting patients’ financial liability in such situations.

What is medical necessity in insurance claims?

Treatments must meet criteria for being essential to diagnose or treat a condition to qualify for coverage.

What are the available options for a patient if an insurance claim is denied?

Patients can file an appeal with their insurance company and escalate the matter to external review or legal action if necessary.

Privacy and Security

What is a data breach in healthcare?

Unauthorized access, use, or disclosure of protected health information (PHI), which violates HIPAA and may harm patient trust.

What are telehealth privacy requirements?

Providers must use secure platforms to comply with HIPAA and protect patient data during virtual consultations.

Can providers share patient data without consent?

Only under specific circumstances, such as public health reporting, emergencies, or legal obligations.

Legal and Ethical Issues

What is the Stark Law?

Federal law prohibiting physicians from referring patients to entities where they or their family members have a financial interest.

What is the False Claims Act?

A federal law that addresses healthcare fraud, such as submitting false claims to government programs like Medicare or Medicaid.

What is whistleblower protection in healthcare?

Laws that protect individuals who report fraud, abuse, or illegal activities from retaliation.

What is the role of an ethics committee in hospitals?

Ethics committees are advisory in issues of complex medical decisions and in settling patient care disputes.

What are the guidelines on the prescription of controlled substances?

Prescribers have to comply with DEA rules and regulations, ensure proper documentation, and monitor misuse or diversion of controlled medications.

What is a duty to report in healthcare?

Providers are obliged to report particular conditions or events, including infectious diseases, child abuse, or elder neglect to the concerned authority.

Public Health and Safety

What is the role of public health laws?

Public health laws deal with disease control, vaccination mandates, and emergency response measures.

What is the importance of vaccination mandates?

Mandates are meant to protect public health by requiring immunizations for school attendance or during outbreaks, with some exemptions.

How do quarantine and isolation laws work?

The government can enforce quarantine or isolation to prevent the spread of contagious diseases under public health authority.

What are patients’ rights during a public health emergency?

Patients maintain basic rights but some liberties could be limited in the interest of public safety.

Health Equity and Non-Discrimination

What does Title VI mean in healthcare?

Title VI bars any form of discrimination on the grounds of race, color, or national origin against beneficiaries of healthcare services that are covered under federally administered programs.

What are the rights of LGBTQ+ patients in healthcare?

Anti-discrimination laws promote equal treatment, access to care, and confidentiality for LGBTQ+ patients.

These include topics on aspects of health law and practice that impact patient care, provider practice, and healthcare systems.