Chapter 2 Government, Law, and Ethics

Provides evidence based information on healthcare outcomes, quality, cost, use and access

Agency for Healthcare Research and Quality (AHRQ)

National Institute of health is responsible for

Biomedical research

Lead federal agency responsible for prevention and control of disease

CDC

Medicare, Medicaid and CHIPS falls under what department which is also responsible for implementing HIPAA.

Centers for Medicare and Medicaid Services (CMS) (Agency under DHHS)

Basic Source of law

Common Law

Derived from judicial decisions

Common Law

Private Law

Concerned with the recognition and enforcement of rights and duties of private individuals.

First common law case in the US in which a physician was held responsible for negligence.

Cross v. Guthery 1794

Public Law

Deal with realationships between individuals and government.

This accounts for more malpractice claim than any other medical condition

Delayed diagnosis of breast cancer due to misdiagnosis, failure to follow-up, and false-negatives.

Agencies that fall under the (PHS)

NIH, CDC, FDA, HRSA, AHRQ, ATSDR, IHS, Substance abuse and mental health services administration.

Separation of powers

No one branch of the government will be dominant over the other two.

Tort Action

One part asserts that the wrongful conduct of another has caused harm and the injured party seeks compensation. (Private Law)

How do most cases reach the Federal Supreme Court

Through the discretionary writ of certiorari (an appeal petition.)

Function of the legislative branch

To enact laws and amend or repeal existing legislation and to create new legislation. 22

States do not have to abide by common law from sister states. T/F

True

Federal appellate court

U.S. Circuit Court of Appeals

Legislative powers are vested in the

U.S. Congress 22

Name for the federal trial court system

US District Court

When reviewed by courts, an agency's regulations and decisions can be ___________ _________ ___________ __________ __________

Upheld, modified, overturned, or reversed and remanded for further proceedings. 21

Court of last resort

Usually a state supreme court

Contract Action

Usually involves a claim by one party that another party has breached an agreement by failing to fulfill an obligation. (Private Law)

Appellate jurisdiction

Where appeals from trial judges are heard

How many U.S. Circuit Courts are there

12 regional and a 13th located in D.C.

Number of cabinets in the executive branch

15

A presidential veto of a bill can be overridden by a

2/3 majority vote in both houses of congress

How many judges sit on the supreme court

8 Associate justices and 1 Chief Justice

Number of federal district courts

94

Branch of law that controls administrative operations of government agencies

Administrative Law 20

Original Jurisdiction

Authority of a court to conduct a trial first

Provides health insurance for individuals over 65 and certain disabled people

Medicare

Main source of regulations affecting the healthcare industry

Department of Health and Human Services

DHHS is charged with...

Developing and implementing appropriate administrative regulations for carrying out national health and human services policy. (Department)

Supervises and control drugs, food, cosmetics and medical devices into the market place

FDA

When federal and state law conflicts resolution is found in

Federal Courts21

Mission is to improve access to healthcare services for people who are uninsured, isolated or medical vulnerable

Health Resource and Services Administration (HRSA)

Sources of Public Policy

Legislation, administrative rules, regulations, judicial decisions

Stare decisis

Let the decision stand (when a decision is rendered in a lawsuit of the exact same type; future law suits must be ruled on in the same manner)

Court Jurisdiction is based on

Location of those involved and where the issue occurred

Provide medical services for the medically needed

Medicaid

_________ Is jointly funded by the federal and state government however; the states establish their own criteria for determining eligibility

Medicaid

Administrative Law

Prescribed by administrative agencies.

Public Health Services (PHS) is responsible for

Promoting the protection of the nation's physical and mental health.

Law

Rules of conduct enforced by government

What are the two houses of congress

Senate and House of Representatives 22

Common law can be abolished by

Status law - by express words

Mission is to reduce the impact of substance abuse and mental illness

Substance abuse and mental health services administration

The only federal court created directly by the constitution

The Supreme Court

What takes precedence over the constitution and law of individuals states

The U.S. Constitution, federal law, and federal treaties.

Rules and regulations of an administrative agency cannot supersede

The language chosen by congress 21

Exercise's leadership in the executive branch to prevent conflicts of interests on the part of government employees and resolve conflicts that do occur with the goal of increasing public trust.

The office of Government Ethics Founded 1978 Part of the executive branch

Res judicata

The thing is decided (has been previously acted on or decided by the courts

Function of the Executive Branch

administer and enforce the law

Federal District courts hear...

civil, criminal, admiralty, and bankruptcy cases

A statute can abolish a

common law

Cases are tried applying ________ _________ principles unless a ___________ __________

common law ; statute governs

Statutory Law

emanates from the federal and state legislature

HIPPA requires DHHS to

establish national standards of electronic healthcare transactions, national identifiers for providers, health plans and employers. It also addresses patient privacy.

A Bill may be reported out of committee as

favorable, unfavorable, with amendments or allowed to lie in committee without action

States can only enact and enforce laws that do not conflict with

federal laws

Medicare Part A pays for

inpatient hospital care, nursing homes, home health and hospice care.

Agency regulations and administrative decisions are subject to ______________ ____________

judicial review 21

Public Policy

no one can lawfully do that which tends to be injuries to the public or against the public good.

Medicare Part B covers

physicians services and outpatient hospital services.