Ethical and Legal Considerations- Sports Medicine

Liability

the state of being legally responsible for the harm one causes another person

Negligence

the failure to use ordinary or reasonable care

Standard of Reasonable Care

assumes that an individual is a person of reasonable and ordinary prudence

Duty of Care

a requirement that a person act toward others and the public with watchfulness, attention, caution and prudence that a reasonable person in the circumstances would

Torts

legal wrongs committed against a person

Nonfeasance, or An Act of Omission

when an individual fails to perform a legal duty

Malfeasance, or An Act of Commission

when an individual commits an act that is not legally his or hers to perform

Misfeasance

when an individual improperly does something he or she has the legal right to do

Good Samaritan Law

provides limited protection to someone who chooses to provide first aid; does not apply to someone who has a duty to act as dictated by the nature of his or her job

Statute of Limitation

a specific length of time to sue for damages from negligence

Assumption of Risk

the individual, though expressed or implied agreement, assumes that some risk or danger will be involved in the particular undertaking

Managed Care

costs of health care are monitored closely by insurance carriers

Medical Insurance

a contract between the insurance company and the policyholder

Secondary Insurance

pays the athlete's remaining medical bills after a general health insurance plan has made its payment

Reimbursement

comes from the policyholder's insurance company for services provided

Third Party Parties

private insurance carriers

HMOs

PPOs

Health Maintenance Organizations (HMOs)

provides preventive measures and limit where the individual can receive care

Preferred Provider Organizations (PPOs)

provides discount health care but also limit where a person can go for treatment of an illness

Point of Service Plan

a combination of HMO and PPO plans; based on a HMO structure, but also allows members to go outside the HMO to obtain services

Indemnity Plan

not a type of managed care, but is the most traditional form of billing fore health care

Capitation

a form of reimbursement used by manage care providers in which members make a standard payment each month regardless of how much service is rendered to the member by the provider

Medicaid

a health care program for people with low incomes and limited resources

Medicare

a federal health insurance program; for the aged and disabled

Accident Insurance

covers accidents on school grounds while the student is in attendance

Catastrophic Insurance

provides plans that deal with the problem of a lifetime of extensive medical and rehabilitative care because of a permanent disability

National Federation of State High School Associations

catastrophic insurance for secondary schools; provides medical, rehabilitation, and transportation costs in excess of $10,000 not covered by other insurance benefits