Week 3 Assignment - Complete the worksheet. Types of Consent and Payers PDF

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Complete the worksheet. Types of Consent and Payers...

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Ru n n i n gHe a d :T y p e so fCo n s e nta n dPa y e rCh a r t s

We e k3 :Ty p e so fCo n s e n ta n dPa y e r s Marine Kaladjian HCS/ 4 3 0 0 7 / 29 / 2 0 1 9

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Ru n n i n gHe a d :T y p e so fCo n s e n ta n dPa y e rCh a r t s

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Types of Consent and Payers Part 1: Complete the chart and questions that follow. Type of Consent

Define type of consent (20- to 45words).

Identify 4 principles of the consent (20- to 45- words).

Informed Consent

Defined as the

Four principles of the

Describe the impact on the health care industry (45- to 90words). Informed Consent is

process by which a

consent includes (1)

more than a simple

patient becomes

the patient’s diagnosis,

patient’s signature on

informed by their

(2) the nature and

a form but it involves

care provider and

purpose of the

medical ethics, of

comprehends the

proposed treatment or

which overlooked can

need, benefits, and

procedure, (3) the

impact the health care

possible risks factors

advantages and risks

industry in several

involved in a medical

factors of the

ways, such as huge

procedure, and is able

treatment or

financial losses

to give consent and

procedure, and (4) the

through law suits, and

agree for the medical

alternative treatments

violation of federal

procedure to be

that are available to

laws resulting in fines.

performed.

patient, irrespective of

It is important that

cost or insurance

physicians adhere to

coverage (Fremgen,

all aspect of informed

2014).

consent to protect the patient’s right and themselves as well.

Ru n n i n gHe a d :T y p e so fCo n s e n ta n dPa y e rCh a r t s

3 The American Medical Association (AMA) adopted standards of conduct which defines the essentials of honorable behavior for clinicians, of which includes these principles, human dignity, honesty, confidentiality and responsibility to patient (Fremgen,

Implied Consent

When a patient

Implied consent has

2014). Although the health

behavior indicates

same ethical principles

care industry deals

that they are in

as informed consent,

with many medical

acceptance of medical

although a patient

malpractices cases

treatment or

signature is not

that are involved with

procedure, it is

appended on a form,

implied consent, they

considered as implies

the basic principles of

are somewhat difficult

consent (Fremgen,

protecting the patient

to be proven. A

2014)

right must be adhered

thorough investigation

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Ru n n i n gHe a d :T y p e so fCo n s e n ta n dPa y e rCh a r t s to, such as, the

of all facts and events

patient’s diagnosis

that led to the medical

must be known, nature treatment or procedure and purpose of the

must be carefully

treatment or

examined to

procedure, advantages

determine if there

and risks factors of the were any unethical treatment or

laws or principles

procedure, and the

broken. For example,

alternative treatments

implied consent is

that are available to

given during a

patient, irrespective of

patient’s scheduled

cost or insurance

visit to their physician

coverage must be

for an annual checkup,

communicated to

which entails the

patient.

drawing of blood and touching of patient body during examination.

Answer the each of the following questions using 90- to 175- words. 1. Describe 4 exceptions to consent. According to Fremgen (2014), there are three primary consent exceptions when treating patients. The first exception is for performing emergency treatment (Fregen, 2014). However, it

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is necessary to obtain written consent once the patient is able to provide it. The second exception is when there is a language barrier and no one to provide translation (Fremgen 2014). In these instances, consent must be implied. A third exception is when prison inmates are being treated (Fremgen, 2014). There are also exceptions to consent regarding medical records. According to Fremgen (2014), when medical records are subpoenaed they can be released without patient consent. 2. How do exceptions to consent impact the health care industry. Exceptions to consent significantly impact health care. Firstly, physicians can refuse to treat patients who do not consent to treatment (Fremgen, 2014). Also, problems could result from instances where consent is implied. A physician may assume the patient understands the needed treatment, when there are language barriers for example, but the patient may not. Furthermore, a patient may not agree with the emergency treatment received. A physician may do what is necessary to save the patient during an emergency. However, there could still be issues or disagreements after the fact. Therefore, exceptions to consent can increase health care costs. Medical professionals have to purchase costly insurance to protect themselves from malpractice lawsuits. 3. Describe 2 exceptions to consent within your state. In Florida, minors are required to have informed consent from a parent or guardian to receive medical treatment. However, there are exceptions that allow minors to provide informed consent for any medical treatment if they fully understand the risks and benefits. A main exception for minors is being married or having been married before age 18 (“Minors’ Access,” 2005). Also, minors emancipated by the court over the age of 16 can consent to their own treatment (“Minors’ Access,” 2005). Minors who are pregnant can also consent to prenatal care

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(“Minors’ Access,” 2005). Minors can also receive emergency contraceptives (Plan B) and confidential sexually transmitted disease screenings and treatment (“Minors’ Access, 2005”). Furthermore, minors can receive outpatient mental health counseling and substance abuse care without consent from a parent or guardian (“Minors’ Access,” 2005). There are also exceptions to informed consent in Florida when performing a test for HIV. An HIV test can be performed without consent during a medical emergency to provide appropriate care, when mandated by court, or when a healthcare worker has been exposed to a significant blood exposure and the patient’s blood sample has already been obtained for other blood tests (A Train Education, n.d.).

Part 2: Complete the chart. Identify 3 ThirdParty Payers

Describe thirdparty payer (20- to 45words)

Describe the legal issues that regulate the third-party payers (45- to 90-words).

Describe an applicable law that regulates the third-party payers (45- to 90- words).

1.Private Health

Private

With private

Under the

Describe the impact that the legal issue and applicable laws have on the thirdparty payers (45to 90- words). Health insurance

Insurance

Insurance has

health insurance

Affordable Care

issuers in the

plans for

there are tax

Act (ACA),

individual and

individuals to

penalties that a

private health

small group

use to pay for

person will have

insurance

markets would

health care

if they do not

companies are

only be allowed

coverage. Each

have insurance

expected to meet

to vary premiums

company offers coverage.

the minimum

based on factor

health care

standard of

age, family size

Private Health

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coverage that

Insurance covers

coverage for its

and geography

must meet or

a person’s health

participants. The

and tobacco use.

exceed basic

care and assures

ACA demands

Health insurance

standards set

the person is

that health

issuers would be

by state and

receiving the

insurance issuers

required to

federal

proper care and

generally be

maintain a single

government.

without that care

prohibited from

statewide risk

a person receives denying coverage pool for each of a cash penalty

to people

their individual

that comes out

because of a pre-

and small

of their federal

existing

employer

taxes at the end

condition or any

markets

of the year.

other factor.

premiums and

Under the law,

annual rate

states can choose

changes would

to enact stronger

be based on the

consumer

health risk of the

protections than

entire pool. This

these minimum

provision

standards.

prevents insurers from using separate insurance pools

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Ru n n i n gHe a d :T y p e so fCo n s e n ta n dPa y e rCh a r t s within markets to get around the market reforms and to charge people with greater health problems higher premiums by increasing their premiums at higher rates than other, healthier

2.Workers

Is a type of

If workers

Workers’

risk pools. Under worker

Compensation

insurance that

compensation

compensation

compensation

provides wage

insurance benefit

provides a claim

laws sufferers of

replacement

is not offered to

and benefit

an on-the-job

and medical

employees when

system for

injury or illness,

benefits to

the employee

workers who

may be entitled

employees

has the

become ill, are

to workers'

injured on the

opportunity to

injured, or die on

compensation.

job

sue their

the job. To be

Employees who

employer for

covered by

are covered can

medical

workers’

receive partial

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Ru n n i n gHe a d :T y p e so fCo n s e n ta n dPa y e rCh a r t s treatment, and

compensation, an

pay for the time

also weekly or bi injury need not

they are out of

weekly pay that

be caused by a

work,

was missed due

sudden accident.

compensation for

to the injury that

From the

their medical

happened at the

employee’s

bills, and more.

job site. It’s in

standpoint,

Workers are

the jobs best

workers’ comp is

required to seek

interest to offer

a no-fault

immediate

worker

system. It does

medical care if

compensation to

not matter

injury requires it.

avoid being sued

whether a worker

Then the

for the tort or

was careless

employer should

negligence.

when injured.

be notified injuries as soon

3.Medicare and

Medicare is a

To ensure that

As part of the

as possible. The Medicaid

Medicaid

federal

individuals

state-federal

program provides

government

receive

partnership in

federal funding

program that

qualifications for

administering the

to states for

offers health

Medicare and

Medicaid and

medical and

care coverage

Medicaid there

Medicare

health-related

to the elderly

are advocates for

programs, the

services for

over the age of

these federal

Centers for

persons with

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Ru n n i n gHe a d :T y p e so fCo n s e n ta n dPa y e rCh a r t s 65 years old or

programs to

Medicare and

limited income.

that have

enforce the law

Medicaid

Various

severe

and in litigation,

Services (CMS)

provisions of the

disabilities no

and advocating

issues guidance

Act address the

matter the

for Medicaid

in the form of

collection, use,

income.

policies and laws letters to State

and disclosure of

Medicaid is

to ensure that the

Medicaid

Medicare and

offered to

program is

Directors and to

Medicaid

families and

offered to

State Health

beneficiaries’

individuals that

everyone and

Officials. A

health

have low

everyone is

significant

information.

income that is

treated fairly.

portion of the

Even though

provided by

Appeals are

health care

ObamaCare

the state and

offered to those

system in the

“cuts” Medicare;

federal

who feel they

United States is

it isn’t really a

government.

were not treated

governed by the

cut, it is health

fairly or did not

Social Security

care reform

qualify.

Act and its

aimed at

amendments,

improving care

which regulate

for seniors and

federally funded

their families.

health insurance

The fact is,

programs for to

millions more

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Ru n n i n gHe a d :T y p e so fCo n s e n ta n dPa y e rCh a r t s the nation’s most

seniors will be

vulnerable

covered under

populations.

the Affordable Care Act.

Ru n n i n gHe a d :T y p e so fCo n s e n ta n dPa y e rCh a r t s

Reference A Train Education (n.d.) HIV and aids in Florida. Retrieved from https://prh.org/wpcontent/uploads/35307866-Florida.pdf Fremgen, B. F. (2014). Medical law and ethics (5th ed.). Upper Saddle River, NJ: Pearson.

Minor’s access to confidential reproductive healthcare in Florida. (2005). Retrieved from https://prh.org/wp-content/uploads/35307866-Florida.pdf

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