Looks like no one added any tags here yet for you.
Litigation
the process of taking legal action
Judicial system
the court system which provides an avenue to enforce both rights and obligations
Legislative system
enacts laws and controls many activities related to industry (healthcare industry) via statutes
Statutes
often set forth required actions are laws created by legislative bodies
Administrative system
controls governmental administrative operations, operates through federal and state administrative agencies that enact regulations
Regulations
rules derived from or brought forward by administrative agencies subsequent (coming after) to the passage of statutes
Legal system
the mechanism through which members of society settle disputes; these disputes may occur between private individuals and organizations or between either of these entities and the government (can be state, federal, local, or a combination)
Common law (Judicial law)
judge-made law; case law; created by courts that resolve disputes
Precedent
binding force for future cases addressing the same issues
Persuasive authority
guidance using other systems precedents in analyzing a specific legal problem (ex. one state looking to another state’s precedent or lower court systems looking at higher level court)
Stare decisis
“let the decision stand”
states that in lower court cases involving a fact pattern similar to that in a higher court within the same court system, the lower court is bound to apply the decision of the higher court
Statutory law (Legislative law)
written law established by federal and state legislators
it may be amended, repealed, or expanded by the legislature
may be upheld or found by a court to violate or conflict with the state or federal constitution
may be found to conflict with a different state law or federal law
may be revised by a court ruling in terms of its constitutionality and applicability since courts interpret laws in terms of how they apply to a given situation
if legislature disagrees with the court’s interpretation it can revise the statute → the revision then becomes the law instead of the court’s revision based upon interpretation
Administrative law
branch of law that controls the government’s agencies or administrative operations
administrative agencies include: licensing bodies, CMS, and other federal and state government programs
*additionally regulatory agencies can at times function in a legislative, adjudicative, and enforcement role regarding their own regulations
Federal Register
publication issued by the US Government Printing Office used to make agency rules, opinions, orders, records, and proceedings available to the public (required by the Administrative Procedure Act)
Code of Federal Regulations (CFR)
compilation of federal administrative regulations
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
initially focused on making it easier for employees to retain health coverage when they changed jobs or their family status changed
also addresses waste, fraud, and abuse in the healthcare system; created a single federal standard electronic claims format for electronic data exchange and focuses on simplifying the administration of health insurance
published in the Federal Register
Jurisdiction
the right to hear and decide the controversy in a given case
Subject matter jurisdiction
includes federal crimes and constitutional issues
Diversity jurisdiction
where parties do not live in the same state
Trial court
lowest level in the court system
state civil and criminal cases are initiated at this level (has the authority to first hear a case on a given matter → original jurisdiction)
Original jurisdiction
authority to first hear a case on a given matter
Limited jurisdiction
may only hear certain types of cases (some trial courts have this)
General jurisdiction
hear cases of all types
Appellate court (a court of appeals)
(next level up from trial courts) decisions made in a trial court may be appealed to an intermediate court (appellate court)
Supreme court
highest level of court in state legal systems (each state has one)
have general jurisdiction over all cases heard in state’s trial and appellate courts
decisions coming from this level of court in the state hearing a case become the law of that state unless a state legislative process enacts a statute to override the court’s decision or overturned by another case
District courts
94 trials courts in the federal court system
specialized federal courts have exclusive jurisdiction over certain matters such as bankruptcy, customs, and claims against the federal government (these cases of these matters cannot be filed in a state court)
Courts of appeals
appellate courts
there are 13 at the federal level
each of these courts covers a specific geographic region or circuit
Circuit
when the federal appellate courts cover geographic regions but are connected
Circuit courts
courts that review cases heard in federal district court within the court’s circuit
review orders issued by certain administrative agencies
issue original writs in cases as appropriate
Writs
written commands
Petition for writ of certiorari
a request for the US Supreme Court to consider a case
supreme court will either grant certiorari (hear the case) or deny (declines to hear case)
majority of requests are denied
Public law
involves the relationship between the government (at any level) and individuals or organizations; the government IS a party
purposes:
defining
regulating
enforcing rights
Private law
involves the relationship between private entities or individuals; the government is NOT a party
Civil Law
addresses noncriminal legal matters and involves relationships among individuals, corporations, government entities, and other orgs
most actions encountered in healthcare are based on civil law
Plaintiff
party bringing action or complaint in a civil case
Complaint
a legal document that sets forth the facts and claims
Summons
a notice served to the defendant in a civil case
Defendant
party accused of committing the wrong
Answer
defendant’s response to the complaint
Restitution
compensation
Evidence
supporting information
Burden of proof
requisite degree of belief to support the purported claims
varies depending on the type of case
Counterclaim
when the defendant brings a claim back to the plaintiff
Cross-claim
one party may bring a claim against another party who is on the same side of the litigation
Joinder
defendant bringing a claim against an outsider as a co-defendant
Default judgement
when the plaintiff is in favor due to the defendant failing to file a timely answer
Trier of fact
a judge or jury
Settlements
official agreements
Arbitration
where an impartial third party makes a binding decision
Mediation
an objective third party hears a dispute and brings the parties to a mutual agreement
Discovery
consists of both the pretrial period and and the activities by which both the plaintiffs and defendants will obtain information held by other parties to assess the strengths and weaknesses of each parties case
Depositions
sworn statements from the witness
Interrogatories
formal questions
Requests for production
legal request for documents from the opposing party ; requesting a mental and physical examination of a party
Subpoenas
directives to attend or respond to legal proceedings
Motions for summary judgement
both parties argue either that there are or there are not any facts remaining in dispute and that one or the other is or is not entitled to a judgement being entered without the intervention of a trier of fact (judge or jury)
both parties present this
Preponderance of evidence
the plaintiff must prove their case by the burden of proof
Damages
amount of money awarded due to the liability
Adjudicated
formally decided, through the trial court
Res judicata
the same parties may not pursue the case again
Criminal law
addresses crimes or wrongful acts against public health, safety, and welfare
encompasses both conviction and punishment
Conviction
declaration that a party is guilty
Felony
more serious crime (murder and other homicides, rape, assault, and thefts of items or cash in excess of a certain value set by statute
information theft can also be a part of this depending on the case
Misdemeanor
lesser offense
includes:
disorderly conduct
theft of small amounts of property
information theft
Prosecutor
state or district attorney or federal = US attorney
they file charges against the defendant on behalf of the governemnt if enough evidence is found
Grand jury
the jury that in some states must return an indictment for a felony crime to be prosecuted
has the authority to issue subpoenas for its investigative process
all evidence considered by the grand jury remains confidential unless an indictment is issued
Indictment
formal charge
Arraigns
in criminal cases, when a defendant is called before the court and charges are brought by the prosecutor against the defendant
Beyond a reasonable doubt
the burden of proof that the government must meet to establish the defendant’s guilt
Acquittal
when a defendant is found not guilty and then charges are dismissed
Hung jury
if all individuals of a jury cannot agree on defendant’s guilt or lack of proven guilt
Tort
a civil wrong
Tort law
actions brought when one party believes another party caused harm through wrongful conduct
Negligence
acting in an unreasonable manner or failing to act a reasonably prudent person would in similar circumstances
can also be when an individual has evaluated the alternatives and the consequences of those alternatives and has not excised their best possible judgement
Standard of care
what an individual is expected to do or not to do in a given situation
established in a variety of ways:
accrediting bodies or professional associations
statute or regulation
by practice
Malfeasance
the execution of an unlawful or improper act
Misfeasance
improper performance of an act resulting in injury to another
Nonfeasance
failure to act when there is a duty to act as a reasonably prudent person would act in similar circumstances
Ordinary negligence
failure to do what a reasonably prudent person would do or doing something that a reasonably prudent person would not do in the same or similar situation
Gross negligence
extreme departure from the ordinary standard of care that shows a reckless disregard toward others
Criminal negligence
if gross negligence is defined by a criminal statute
Duty of care
an obligation to meet a standard of care within the relationship
Breach of duty of care
plaintiff must present evidence that the defendant acted unreasonably under the circumstances
(failure to follow a standard of care or deviation from standard of care)
Injury or harm
must demonstrate that they suffered an injury or harm as a result of defendant’s negligent act or failure to act
doesn’t just include physical injury but also mental suffering, pain, loss of income or reputation, loss of consortium, and invasion of patient rights and privacy
Causation
must show that defendant’s conduct caused the harm
Actual causation
defendant’s conduct ACTUALLY caused harm
Proximate causation
breach was foreseeable cause of harm
Res ipsa loquitur
“the thing speaks for itself”
element applied in this doctrine:
injury that does not ordinarily occur in the absence of negligence
injury caused by agency or Instrumentally in defendant’s exclusive control
injury not due to voluntary action or contribution of the plaintiff
Intent
person committed an act purposely or knowing that harm would likely occur
Assault
conduct along with apparent ability causing apprehension that physically harmful or offensive contact will occur
(the harm does not actually need to occur for it to be considered assault)
Battery
intentional and nonconsensual touching of another person’s body
False imprisonment
intentional confinement of someone against their will
includes defendant’s lack of legal authority or justification to confine a person
Discharge against medical advice (AMA)
form signed by patient when patient insists on leaving the facility against medical advice and then releases the facility from responsibility
Defamation of character
false communication about someone to a person other than the subject that may injure a the subject’s reputation
Slander
spoken false communication that hurts the subject’s reputation
Libel
Written communication that hurts the subject’s reputation
Fraud
an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to themself or some other person
Invasion of privacy
intrusion upon one’s solitude
Right to privacy
the right to be “let alone”
includes:
rights to be free from surveillance and interference
right to keep one’s information from being disclosed
Infliction of emotional distress
intentional or reckless; mental suffering resulting from despair, shame, grief, and public humiliation
ex. plaintiff shows that the defendant intended to cause mental distress and knew or should have known that their actions would do so