Understanding the regulatory and legal procedures that apply to health care providers, including licensure, certification, and accreditation.
Health Care Regulations: Overview of regulatory bodies, regulatory framework, and regulatory compliance requirements for health care providers, including hospitals, clinics, nursing homes, and other health care organizations.
Licensing: The process of obtaining professional licenses for health care providers, including physicians, nurses, pharmacists, and other health care practitioners. This topic covers the criteria, procedures, and requirements for obtaining a license from the appropriate licensing body.
Malpractice: The legal liability of health care providers for injuries or damages caused to patients resulting from medical negligence, errors, or omission. This topic covers the legal system for medical malpractice claims, including the standard of care, causation, and damages.
Privacy and Confidentiality: The legal obligations of health care providers to protect the privacy and confidentiality of patient health information. This topic covers the privacy and confidentiality requirements under various laws and regulations, such as the Health Insurance Portability and Accountability Act (HIPAA), during treatment and facility operations.
Consent: The legal and ethical requirements for obtaining informed consent from patients before medical treatment, medical research, or other medical procedures. This topic covers the elements of informed consent, capacity to consent and the requirements for informed consent that depends upon the type of medical procedure involved.
Medication Safety: The legal and ethical obligations of health care providers to ensure the safe prescribing, dispensing, and administering of medications. This topic covers practices that promote medication safety, such as prescription labeling, patient education, and medication reconciliation.
Health Care Fraud and Abuse: The laws and regulations that prohibit fraudulent and abusive practices by health care providers, such as billing for services not rendered or submitting false claims. This topic covers the federal False Claims Act, Stark Law, Anti-Kickback Statute, and associated regulations.
Medical Records: The legal and ethical requirements for maintaining accurate, complete, and confidential medical records. This topic covers the policies and procedures for creating, storing, sharing, and disposing of patient medical records.
Telemedicine: The legal and regulatory requirements for telemedicine services, including remote consultations, remote monitoring and other substitute forms of healthcare delivery. This topic covers state-specific telemedicine laws, licensing and regulatory requirements for physicians, billing implications for telemedicine visits and technologies.
Health Care Management: Overview of the organizational structure, management, governance, and quality assurance requirements of health care providers, including hospitals, clinics, and nursing homes. This topic covers the roles and responsibilities of health care management teams and the systems in place to monitor and manage patient care.
Licensure: The process by which states and other jurisdictions issue licenses to health care professionals who have demonstrated the required qualifications to provide health care services to the public.
Certification: The process by which a professional organization, such as a board or association, grants recognition to an individual healthcare professional that the professional has met certain minimum qualifications that are not required by law.
Accreditation: The process by which healthcare facilities and services are evaluated to determine if they meet certain regulatory and performance standards.
Credentialing: The process by which healthcare organizations determine the qualifications, competence, and professional background of healthcare providers who want to join their organizations.
Scope of Practice: The legal and professional boundaries that define the services that healthcare providers are authorized to perform based on their education, training, and skill sets.
Liability: The legal obligation of healthcare providers to compensate patients for injuries or damages caused by their negligence or malpractice.
Quality Assurance: The process by which healthcare organizations evaluate and improve the quality of their services to ensure patients receive consistent, high-quality care.
Health Information Privacy and Security: The laws and regulations that govern the use and disclosure of personal health information to protect the privacy of patients.
Medicare and Medicaid Regulations: The rules and regulations that govern the eligibility, coverage, and payment for healthcare services provided to beneficiaries of the Medicare and Medicaid programs.
Prescription Drug Regulations: The laws and regulations that govern the manufacture, distribution, and dispensing of prescription drugs to ensure their safety and efficacy.
Medical Device Regulations: The laws and regulations that govern the design, manufacture, and use of medical devices to ensure their safety and effectiveness.
Telemedicine Regulations: The laws and regulations that govern the delivery of healthcare services through electronic communication technologies.
Public health regulations: The laws and regulations that govern the prevention, detection, and response to public health threats and emergencies.
Human subject research regulations: The laws and regulations that govern the ethical conduct of research involving human subjects to protect their safety and welfare.