Law: Ch 15-19
T or F The National Regulatory Commission (NRC) posts daily medical events related to radiation on their website which includes PHI in addition to the location and reporting person.
F
T or F A covered entity cannot disclose a patient's PHI to a public health entity even if it is to prevent the spread of a disease unless the patient authorizes the disclosure.
False
T or F A non-reviewable sentinel event would be the suicide of a patient with 72 hours of discharge from a facility.
False
T or F A patient must allow their health information to be shared with a health information exchange.
False
T or F A risk and opportunity identification process is very useful since it can predict all risks an organization may be exposed to.
False
T or F Abuse of the elderly is limited to physical neglect of an elder person.
False
T or F All billing errors that result in overpayments by a Federal healthcare program should be reported to the government through the Provider Self-Disclosure Protocol.
False
T or F An employer is entitled to information about an employee's health or medical work fitness for work and non-work related health information.
False
T or F Attorneys have automatic access to patient information because they are officers of the court.
False
T or F Because implants are classified as Class III medical devices they are not regulated by the FDA, thus PHI would not be found in an implant registry.
False
T or F CLIA prohibits a patient from accessing lab results directly for the laboratory conducting the test.
False
T or F Documents not considered part of the LHR—for example, correspondence, incident reports, and information about other family members—should be released as part of the LHR.
False
T or F HIPAA does distinguish highly sensitive health information from other types of health information.
False
T or F HIPAA does not allow the disclosure of personal health information on a patient who has contacted a disease that is monitored in by public health officials without the patient's authorization.
False
T or F HIPAA requires that for the purpose of accounting of disclosures, only PHI that has been released electronically or in writing must be accounted for.
False
T or F Healthgrades represents one of many required programs for reporting of quality and patient safety measures.
False
T or F Hospitals may choose to contact the NPDB when reviewing an individual's credential for staff privileges.
False
T or F Hospitals were exonerated from liability as a result of the Darling vs. Charleston landmark case.
False
T or F If a practitioner is assigned a medical staff category of "associate," he or she can chair the medical staff executive committee.
False
T or F It is best policy to provide a special mark or notice on an HIV/AIDS patient health record in order to ensure extra privacy precautions on the record.
False
T or F Only the adult adoptee can decide if he or she may access the health information of his or her biological parents for health risk purposes.
False
T or F Oversight of the compliance program is primarily the responsibility of the organization'sgeneral counsel.
False
T or F Paying physicians for referrals is a practice encouraged by Medicare.
False
T or F Psychotherapy notes are always part of the behavioral health record.
False
T or F Regardless of the type of request made, if the request is from the patient, a formal authorization form is required per the HIPAA Privacy Rule.
False
T or F Risks are always isolated and remain confined to one area.
False
T or F Safety work products related to adverse event data that are shared with PSOs are always discoverable in a litigation situation.
False
T or F The Deficit Reduction Act extended the application and scope of the current civil monetary penalty and exclusion authorities beyond programs funded by HHS to all Federal health care programs.
False
T or F The Medicare Fee-for-Service improper payment rate calculated through the Comprehensive Error Rate Testing (CERT) program is widely regarded to be an accurate reflection of the true size of the fraud, waste, and abuse problem.
False
T or F The Stark Law is another name for the Anti-Kickback Statute.
False
T or F The Stark Law is the government's primary litigation tool for combating fraud.
False
T or F The executive committee of the medical staff does not have to follow the medical staff bylaws.
False
T or F The federal government's primary approach to combating healthcare fraud is "pay and chase."
False
T or F The medical staff has the ultimate responsibility for the quality and financial well-being of the health organization.
False
T or F The reporting of quality measures that includes PHI is mandatory by federal law.
False
T or F The responsibility for notifying individuals who have had contact with an individual with an infected communicable disease is the person who has the disease.
False
T or F The seven fundamental elements of an effective compliance program recommended by the OIG are based on HHS regulatory standards.
False
T or F Title II of GINA focuses allows employers to use genetic information to make employment decisions.
False
T or F Waivers of the Stark Law, False Claims Act, and the Civil Monetary Penalties Law provision relating to beneficiary inducements apply to certain ACO arrangements.
False
T or F When a physician applies for staff privileges a hospital must query the NPDB only if the physician requests that the hospital does so.
False
T or F When a provider is excluded from Federal healthcare programs, services he orders for a beneficiary of one of these programs will be paid as long as the service is furnished by a non- excluded provider.
False
T or F When an employee is injured at work he must authorization disclosure of his PHI before it can be reported to OSHA.
False
T or F If an overpayment is not returned to Medicare within 30 days, it becomes a violation of the False Claims Act.
False - 60 days
T or F For a provider to be liable under the False Claims Act, there must be proof of a specific intent to defraud.
False- suspicion
T or F A claims management program can help prevent financial loss if an adverse event occurs.
True
T or F A corporate compliance program is an internal set of policies, processes, and procedures that an organization implements to help it act ethically and lawfully.
True
T or F A hospital must report to the CMS Regional Office the death of a patient within 24 hours after the patient has been removed from restraint.
True
T or F A root cause analysis process includes developing a process to prevent reoccurrence of the event.
True
T or F An adoptee's birth record is restricted in order to protect the biological parent(s) unless both parties have agreed to have their identities disclosed in a mutual consent registry.
True
T or F An effective compliance program is a mitigating factor in reducing a provider's liability under fraud and abuse laws.
True
T or F An emancipated minor may authorize for disclosure of his or her health information.
True
T or F An incident report should be completed by an individual who was involved or witnessed the event.
True
T or F Billing for services never rendered is one of the most common types of healthcare fraud.
True
T or F Depending on state law, an individual may access his or her PHI housed in an immunization registry.
True
T or F Detection of compliance violations is an important part of an effective compliance program.
True
T or F Employees directly involved in patient care do not require authorization to access the patient'srecord.
True
T or F For a substance abuse program to be in compliance with the Privacy Rule, the authorization of disclosure of information should include specific elements required by the Privacy Rule.
True
T or F HHS and CMS quality strategies are guided by 3 aims - better care, healthy people/healthy communities and affordable care.
True
T or F Health organizations and providers may charge a reasonable fee as set by state law for copying health records in response to a request for patient information.
True
T or F Healthcare providers must report their suspicion of child abuse.
True
T or F In absence of a legal executor or administrator of an estate, states may follow the UHCDA to allow access to the health records of a deceased patient.
True
T or F In the case of a suspicious death, a medical examiner or coroner has the right to receive medical information without authorization.
True
T or F Individuals who report neglect or abuse of children are protected from civil liability as long as they are reporting their concern in good faith.
True
T or F Information reported without patient authorization under federal laws should be included in the Notice of Privacy Practices.
True
T or F Joint Commission-accredited organizations are expected to have an organization wide, integrated patient safety program.
True
T or F Medical staff bylaws are considered a contract and are legally binding in most states.
True
T or F Mergers of healthcare organizations are subject to the Sherman Antitrust Act.
True
T or F Occurrence screening refers to analyzing records for evidence of unplanned or unexpected events.
True
T or F Ownership of a health record has traditionally been granted to the provider.
True
T or F Patient safety is the ultimate goal of quality improvement and risk management activities.
True
T or F Proof of a requester's relationship to a patient must be verified before health information is released to the requester.
True
T or F Providers who engage in peer review activities relate to patient safety and quality of healthcare have legal immunity for their involvement.
True
T or F Risk management programs are most commonly governed by state law.
True
T or F Risk-sharing arrangements are a Stark Law exception to the referral prohibition.
True
T or F Some electronic health record features increase fraud and abuse risks.
True
T or F Some states provide that physical and mental health of a minor adoptee be given to the adoptive parents at the time of the adoption.
True
T or F State required reporting laws are an exception to the doctrine of preemption.
True
T or F States can modify birth and death certificate information as long as certificates contain the minimum data required by the NCHS.
True
T or F Statewide cancer registries are frequently required to report data to the NCHS.
True
T or F The FDA does not regulate electronic health records but it does regulate a number of health IT applications that may pose a risk to the health or safety of a patient.
True
T or F The Freedom of Information Act, along with state open records laws including public records or sunshine laws, enables federal or state entities to protect personal health information from public access.
True
T or F The Government Accountability Office recommended that increased use of prepayment edits would help prevent improper Medicare payments.
True
T or F The Health Care Fraud Prevention and Enforcement Action Team (HEAT) uses real-time data analysis to investigate healthcare fraud cases.
True
T or F The Patient Protection and Affordable Care Act added penalties for failing to report or return a known overpayment.
True
T or F The classification of medical staff membership impacts a provider's ability to admit patients to a healthcare facility.
True
T or F The duty-to-warn obligation enables a physician to disclose information to a third party who may be the victim of harm perpetrated by a patient.
True
T or F The patient or family does not have the right to restrict a healthcare provider from disclosing PHI if the disclosure is required by state compensation laws.
True
T or F The primary difference between fraud and abuse is intention.
True
T or F Title I of GINA prohibits the use of genetic information by health plans for underwriting purposes.
True
T or F To fit within the Anti-Kickback Statute safe harbor for "electronic health records items and services," the software must be interoperable.
True
T or F Transplant registries may include data about organ donors as well as organ recipients.
True
T or F Healthcare providers voluntarily report confidential quality and patient safety data on events that adversely affected patients to Patient Safety Organizations.
True
T or F Organizations are encouraged to self-report sentinel events to the Joint Commissions Sentinel Event Database.
True
T or F The Joint Commission Patient Safety Goals include many requirements that support the significance of proper clinical documentation.
True
