LibGuides: PMA08-4 Medical Law and Ethics: Legal Resources

Selected Medical Laws and Ethics

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Medical Laws & Acts

Americans with Disabilities Act (ADA)
Children's Health Insurance Program (CHIP)
CHIP provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. In some states, CHIP covers pregnant women. Each state offers CHIP coverage, and works closely with its state Medicaid program.
Comprehensive Long-Term Care Act of 1997 Comprehensive Long-Term Care Act of 1997 - Amends title XVIII (Medicare) of the Social Security Act to: (1) extend Medicare part A (Hospital Insurance) coverage of extended care services to chronically dependent individuals; and (2) provide for coverage of home care services and outpatient prescription drugs under Medicare part B (Supplementary Medical Insurance). Provides for application of a deductible in determining the amount of an individual's payment for covered prescription drugs. Requires the Secretary of Health and Human Services to: (1) establish a program for assuring appropriate prescribing and dispensing practices for covered prescription drugs; (2) develop, and update annually, an information guide for physicians on wholesale drug prices; and (3) report to the Congress on the prices of prescription drugs and their use by individuals eligible for Medicare part B benefits. Requires pharmacies to enter into an agreement with the Secretary in order to receive payment for prescription drugs dispensed to such individuals. Requires the Secretary to establish a point-of-sale electronic system for use by carriers and pharmacies in the submission of information on prescription drugs dispensed. Authorizes sanctions against pharmacies that violate their agreement with the Secretary. Limits the length of prescriptions.
Consolidated Omnibus Budget Reconciliation Act (COBRA) The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102% of the cost to the plan. COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end. COBRA outlines how employees and family members may elect continuation coverage. It also requires employers and plans to provide notice.
Developmental Disabilities Act of 1984
An act to revise and extend programs for persons with developmental disabilities.
Emergency Medical Treatment and Labor Act (EMTALA) n 1986, Congress enacted the Emergency Medical Treatment & Labor Act (EMTALA) to ensure public access to emergency services regardless of ability to pay. Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services to provide a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual's ability to pay. Hospitals are then required to provide stabilizing treatment for patients with EMCs. If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented.
Family and Medical Leave Act (FMLA) of 1993 The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave. Twelve workweeks of leave in a 12-month period for: the birth of a child and to care for the newborn child within one year of birth; the placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement; to care for the employee’s spouse, child, or parent who has a serious health condition; a serious health condition that makes the employee unable to perform the essential functions of his or her job; any qualifying exigency arising out of the fact that the employee’s spouse, son, daughter, or parent is a covered military member on “covered active duty;” or Twenty-six workweeks of leave during a single 12-month period to care for a covered servicemember with a serious injury or illness if the eligible employee is the servicemember’s spouse, son, daughter, parent, or next of kin (military caregiver leave).
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On July 16, 2020, Wage and Hour Division announced a Request for Information (RFI) to be published in the Federal Register seeking the public’s feedback on the administration and use of the law. Learn more about the RFI on FMLA.
Federal Patient Self-Determination Act Most hospitals, nursing homes, home health agencies, and HMO's routinely provide information on advance directives at the time of admission. They are required to do so under a federal law called the Patient Self-Determination Act (PSDA).
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The PSDA simply requires that most health care institutions (but not individual doctors) do the following:

1. Give you at the time of admission a written summary of:

your health care decision-making rights (Each state has developed such a summary for hospitals, nursing homes, and home health agencies to use.)
the facility's policies with respect to recognizing advance directives.
2. Ask you if you have an advance directive, and document that fact in your medical record if you do. (It is up to you to make sure they get a copy of it).

3. Educate their staff and community about advance directives.

4. Never discriminate against patients based on whether or not they have an advance directive. Thus, it is against the law for them to require either that you have or not have an advance directive.
Health Information Technology for Economic and Clinical Health Act 2009 (HITECH) The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009, to promote the adoption and meaningful use of health information technology. Subtitle D of the HITECH Act addresses the privacy and security concerns associated with the electronic transmission of health information, in part, through several provisions that strengthen the civil and criminal enforcement of the HIPAA rules.
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Section 13410(d) of the HITECH Act, which became effective on February 18, 2009, revised section 1176(a) of the Social Security Act (the Act) by establishing:

Four categories of violations that reflect increasing levels of culpability;
Four corresponding tiers of penalty amounts that significantly increase the minimum penalty amount for each violation; and
A maximum penalty amount of $1.5 million for all violations of an identical provision.
It also amended section 1176(b) of the Act by:

Striking the previous bar on the imposition of penalties if the covered entity did not know and with the exercise of reasonable diligence would not have known of the violation (such violations are now punishable under the lowest tier of penalties); and
Providing a prohibition on the imposition of penalties for any violation that is corrected within a 30-day time period, as long as the violation was not due to willful neglect.
Health Insurance Portability and Accountability Act (HIPAA) of 1996 The Standards for Privacy of Individually Identifiable Health Information (“Privacy Rule”) establishes, for the first time, a set of national standards for the protection of certain health information. The U.S. Department of Health and Human Services (“HHS”) issued the Privacy Rule to implement the requirement of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).1 The Privacy Rule standards address the use and disclosure of individuals’ health information—called “protected health information” by organizations subject to the Privacy Rule — called “covered entities,” as well as standards for individuals' privacy rights to understand and control how their health information is used. Within HHS, the Office for Civil Rights (“OCR”) has responsibility for implementing and enforcing the Privacy Rule with respect to voluntary compliance activities and civil money penalties.
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A major goal of the Privacy Rule is to assure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high quality health care and to protect the public's health and well being. The Rule strikes a balance that permits important uses of information, while protecting the privacy of people who seek care and healing. Given that the health care marketplace is diverse, the Rule is designed to be flexible and comprehensive to cover the variety of uses and disclosures that need to be addressed.
Mental Health Parity and Addiction Equity Act 2008
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that generally prevents group health plans and health insurance issuers that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits.
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MHPAEA originally applied to group health plans and group health insurance coverage and was amended by the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the “Affordable Care Act”) to also apply to individual health insurance coverage. HHS has jurisdiction over public sector group health plans (referred to as “non-Federal governmental plans”), while the Departments of Labor and the Treasury have jurisdiction over private group health plans.
Older American Act of 1964 Congress passed the Older Americans Act (OAA) in 1965 in response to concern by policymakers about a lack of community social services for older persons. The original legislation established authority for grants to states for community planning and social services, research and development projects, and personnel training in the field of aging. The law also established the Administration on Aging (AoA) to administer the newly created grant programs and to serve as the federal focal point on matters concerning older persons.
Patient Protection Act of 1997
A bill to assure fairness and assistance to patients and health care providers, and for other purposes.
Patient Protection and Affordable Care Act (PPACA) The first part of the comprehensive health care reform law enacted on March 23, 2010. The law was amended by the Health Care and Education Reconciliation Act on March 30, 2010. The name “Affordable Care Act” is usually used to refer to the final, amended version of the law. (It’s sometimes known as “PPACA,” “ACA,” or “Obamacare.”) The law provides numerous rights and protections that make health coverage more fair and easy to understand, along with subsidies (through “premium tax credits” and “cost-sharing reductions”) to make it more affordable. The law also expands the Medicaid program to cover more people with low incomes.
Patient Rights Act of 2001 Patients' Bill of Rights Act of 2001 - Sets forth provisions concerning group health plans and health insurers and the provision of certain advice and care, including: (1) emergency care; (2) obstetric and gynecological care; (3) specialists care; (4) prescription drugs; (5) participation in approved clinical trials; and (6) health plan information. Amends the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code to, among other things: (1) provide for review and appeal of health plan decisions; (2) provide penalties for health plans failing to provide benefits; (3) provide for patient protection standards; (4) repeal the limitation on the number of Archer Medical Savings Accounts and increase the deduction for contributions to such accounts; and (5) set forth rules governing association health plans.
Prescription Drug Coverage 2003
Provide seniors with prescription drug benefits and more choices in health care.
Rehabilitation Act of 1973 The Rehabilitation Act of 1973 requires access to programs and activities that are funded by Federal agencies and to Federal employment. The law also established the Access Board (section 502). Later amendments strengthened requirements for access to electronic and information technology in the Federal sector (Section 508). With passage the Patient Protection and Affordable Care Act in 2010, a new provision (section 510) was added to address access to medical diagnostic equipment. The Board plays a lead role in developing and maintaining standards for electronic and information technology under section 508 and medical diagnostic equipment covered by section 510.

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Selected Open Source Government Database Resources

Congress.gov

Congress.gov is the official website for U.S. federal legislative information. The site provides access to accurate, timely, and complete legislative information for Members of Congress, legislative agencies, and the public. It is presented by the Library of Congress (LOC) using data from the Office of the Clerk of the U.S. House of Representatives, the Office of the Secretary of the Senate, the Government Publishing Office, Congressional Budget Office, and the LOC’s Congressional Research Service.

California Legislative Information

A public access database provided by the California State Legislature containing the full text of bills, resolutions, and constitutional amendments, and their status, history, votes, analyses, and veto messages. Allows the user to search by legislative session, House of origin, and/or bill number.

The Supreme Court Database

As important as the U.S. Supreme Court decisions are, accessing, reading, and deciphering them can be an arduous task. However, the Supreme Court Database can help relieving some of the difficulty with SCDB Web 101". Visitors should click on "View the 101 Lessons" on the far right hand side of the page

Oregon State Legislature

Official Oregon State Legislature Website. Find information on the State of Oregon Senate, House, Bills and LAws, Committees, Citizen Engagement, and Capital Offices.

National Drug Code Directory

The Drug Listing Act of 1972 requires registered drug establishments to provide the Food and Drug Administration (FDA) with a current list of all drugs manufactured, prepared, propagated, compounded, or processed by it for commercial distribution. (See Section 510 of the Federal Food, Drug, and Cosmetic Act (Act) (21 U.S.C. 360)). Drug products are identified and reported using a unique, three-segment number, called the National Drug Code (NDC), which serves as a universal product identifier for drugs. FDA publishes the listed NDC numbers and the information submitted as part of the listing information in the NDC Directory which is updated daily. The information submitted as part of the listing process, the NDC number, and the NDC Directory are used in the implementation and enforcement of the Act. NDC Directory Search National Drug Code Directory Searchable database NDC Database File - Text Version (Zip Format) Last updated:3/5/2018 NDC Database File - Excel Version (Zip Format) Last updated:3/5/2018 NDC Product File Definitions Product File Data Elements, Definitions, and Notes NDC Package File Definitions Package File Data Elements, Definitions, and Notes.

CDC Stacks Public Health Publications

CDC Stacks is a free, digital archive of scientific research and literature produced by the Centers for Disease Control and Prevention (CDC). This online archive is composed of curated collections tailored for public health research needs. This repository is retained indefinitely and is available for public health professionals, researchers, as well as the general public.

HG.org Legal Resources

HG.org Law Center includes over 70 core areas of law which are then broken down into 260 sub areas of practice. The Center provides information on US (Federal and State), European and International Laws. An abundance of information dealing with the specific area of law is also integrated into each page, including: Publications, Articles, Organizations, Resources, Attorneys and Law Firms.

PMA08-4 Medical Law and Ethics: Legal Resources