Law & Ethics Ch. 3 – Flashcards

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LCRA: involves a mandatory credentialing process established by law, usually at the state level
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Licensure
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LCRA: involves simply paying a fee
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Registration
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LCRA: involves a voluntary credentialing process, usually national in scope, most often sponsored by a private sector group
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certification
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LCRA: required of all physicians, dentists and nurses in every state
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licensure
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LCRA: consists simply of an entry in an official record
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registration
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LCRA: a process that implies that health care facility's or HMOs have met certain standards
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accredidation
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which of the following is madatory for certain health professionals to practice in their field
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licensure
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licensure to practice medicine is done by
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each individual state
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which of the following statements best defines accreditation
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process for officatially authorizing health care education programs, facilities, and managed care plans
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which of the following best defines the osteopathic approach to medicine
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emphasizes musculoskeletal system of the body and the correction of joint and tissue problems
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allopathic medicine means, literally,
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different suffering
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which of the following is an example of tertiary care setting
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Endoscopic center
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which of the following is an explanation for the increasing number of medical specialists
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More scholarships available for med students
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a physician fails to meet continuing education requirements. he or she is guilty of
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unprofessional conduct
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which of the following is not a purpose of medical practice acts
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to be sure physicians are adequatly compensated for their services
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each states medical practice acts also provide for the establishment of
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Medical boards
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laws vary from state to state, but unprofessional conduct for medical professionals usually uncludes
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phtsical abuse of a patient inadequate record keeping failure to meet CEU's
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physicians actions generally classified as fraud include
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falsifying med diplomas and other credentials falisying med reports promising a patient secret cures or other special ways to cure an aliment
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the sole authority granted to the federal government in the licensing of physicians is
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the permit issued by the drug enforcement administration for controlled substance
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physicians today practice primarily
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in group practices
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when two or more physicians practice together, which a written agreement specifying the rights, obligations and responsibilities of each partner, what is the arrangement called?
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a partnership
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what is an advantage to forming a professional corporation to practice medicine
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the incorporators and owners have limited liability in lawsuits
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which of the following best defines a managed care health plan
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a corporation that pays for and delivers care to subscribers
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what is a copayment
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a set amount that each patient pay for each office visit
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under this type of plan, insured patients must designate a primary care physician (PCP)
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gatekeeper or primary care plan
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when physicians, hospitals and other health care providers contract with one or more HMOs or directly with employers to provide care, what is it called
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a physician hospital organization
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under this type of plan, a patient may see providers outside the plan, but the patient pays a higheer portion of the fees
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prefered provider plan
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the national practitioner data bank
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only to hospitals and health care plans
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the patients bill of rights
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Has still not become a law
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the recent federal law provides for the establishment of state run insurance exchanges
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Patient protection and affordable care act
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which of the following is not a stated goal of the health insurance portability and accountability act
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??ensures every person has health insurance
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which of the following statements best defines telemedicine
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med that is practices via phone, tv, fax or internet
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cyber medicine involves
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direct online contact between physicians and patients
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e-health refers to
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increasing use of the internet for consumer health info
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accreditiaion
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official authorization or approval for conforming to a specified standard.
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allopathic
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-literally,"different suffering"; referring to the medical philosophy that dictates training physicians to intervene in the disease process, through the use of drugs and surgery.
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associate practice
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a medical management system in which two or more physicians share office space and employees but practice individually.
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certification
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voluntary credentialing process whereby applicants who meet specific requirements may receive a certificate.
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corporation
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a body formed and authorized by law to act as a single person.
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cybermedicine
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a form of telemedicine that involves direct contact between patients and physicians over the internet, usually for a fee.
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e health
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term used for use of the Internet as a source of consumer information about health and medicine.
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endorsement
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the process by which a license may be awarded based on individual credentials judged to meet licensing requirements in a new state.
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federal false claims act
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a law that allows for individuals to bring civil actions on behalf of the U.S. government for false claims made to the federal government, under a provision of the law called qui tam.
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gate keeperphysician
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the primary care physician who directs the medical care of HMO members.
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group practice
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a medical management system in which a group of three or more licensed physicians share their collective income, expenses, facilities, equipment, records, and personnel.
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health care and education reconciliation act
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enacted in 2010, a federal law that added to regulations imposed on the insurance industry by Patient Protection and Affordable Care Act.
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health care quality improvement act of 1986
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a federal statue passed to improve the quality of medical care nationwide. One provision established the National Practitioner Data Bank.
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healthcare integrity an protection data bank
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a national health care fraud and abuse date collection program established by HIPAA for the reporting and disclosure of certain adverse actions taken against health care providers, suppliers, or practitioners.
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health insurance portability and accountability act (HIPPA)
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a federal law passed in 1996 to protect privacy and other health care rights for patients. The act help workers keep continuous health insurance coverage for themselves and their dependents when they change jobs, and unauthorized disclosure and/or use. It was also intended to help curb the rising cost of health care fraud and abuse.
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health maintenance organization
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health plan that combines coverage of health care costs and delivery of health care for prepaid premium.
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indemnity
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a traditional form of health insurance that covers the insured against a potential loss of money from medical expenses resulting from an illness or accident.
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individual practice association
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a type of HMO that contracts with groups of physicians who practice in their own offices and receive a per-member payment from participating HMOs to provide a full range of health services for HMO members.
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licensure
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a mandatory credentialing process established by law, usually at the state level, that grants the right to practice certain skills and endeavors.
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managed care
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a system in which financing, administration, and delivery of health care are combined to provide medical services to subscribers for a prepaid fee.
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medical boards
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bodies established by the authority of each state's medical practice acts for the purpose of protecting the health, safety, and welfare of health care consumers through proper licensing and regulation of physicians and other health care practitioners.
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medical practice acts
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state law written for express purpose of governing the practice of medicine.
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national practitioner data bank
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a repository of information about health care practitioners, established by the Health Care Quality Improvement Act of 1986.
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open access plan
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managed care feature whereby subscribers may see an in-network health care provider without a referral.
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partnership
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a form of medical practice management system whereby two or more parties practice together under a written agreement specifying the rights, obligations, and responsibilities of each partner.
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patient protection and affordable care act
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a federal law enacted in 2010, to expand health insurance coverage and otherwise regulate the health insurance industry. Many provisions of the law were scheduled to take effect I 2014 and 2015.
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physician hospital organization
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health care plan in which physicians join with hospitals to provide a medical care delivery system and then contract for insurance with a commercial carrier or an HMO>
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point of service plan
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health care fro nonnetwork physicians but pays the highest benefits for care when it is given by the primary care physicians (PCP) or via a referral from the PCP.
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preferred provider association
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...
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preferred provider organizaion
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network of independent physicians, hospitals, and other health care providers who contract with an insurance carrier to provide medical care at a discount rate to patients who are part of the insurer's plan. Also called preferred provider association (PPA)
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primary care physician
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physician responsible for direction all of a patient's medical care and determining whether the patient should be referred for specialty care.
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reciprocity
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process by which a professional license obtained in one state may be accepted without reexamination.
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regrestration
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credentialing procedure whereby one's name is listed on a register as having paid a fee and/or met certain criteria within a profession.
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sole proprietorship
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form of medical practice management in which a physician practices alone, assuming all benefits and liabilities for the business.
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telemedicine
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remote consultation by patients with physicians or other health professionals via telephone, closed-circuit television, or the Internet.
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tertiary care settings
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those care settings providing highly specialized services.
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