Exam Flashcards
(236 cards)
1
Q
Who does the medical practice act apply to?
A
Physicians in Texas.
And physicians located in another state whom practice medicine through telemedicine.
2
Q
How long to appeal any decision made by the board regarding malpractice claims?
A
30 days.
3
Q
For triplicate prescriptions, who must hold on to the copies and for how long?
A
The physician, pharmacy and the Department of Public Safety should each keep a copy for 2 years.
4
Q
What must physicians who dispense drugs do by way of registration?
A
Maintain separate registration at each office site and renew registration every 3 years.
5
Q
How many drugs can physicians dispense from their office?
A
No more than 7 days supply.
6
Q
Adverse event that led to unanticipated transport of a patient to hospital for more than 24 hours observation…
OR
Death of patient within 72 hours of procedure.
A
Board must be notified within 15 days by physician.
7
Q
Time frame for report regarding elderly abuse in nursing homes.
A
Oral report - immediately.
Written report - within 5 days.
8
Q
Time frame for report of a nursing home death.
A
Within 24 hours of nursing home resident being transferred to a hospital.
9
Q
Time frame for report of child abuse…
A
Within 48 hours of professional first suspecting child abuse/neglect.
10
Q
How long do HMOs have to respond to a clean paper bill?
A
45 days…
After which prompt payment is due or written denial for medical fee payment is necessary.
11
Q
Reportable conditions (that endanger the public):
Anthrax, Smallpox, Polio, Hepatitis, Diphtheria, Meningitis, Rabies.
A
Immediately.
12
Q
Reportable conditions:
TB, Pertussis.
A
Within 24 hours.
13
Q
Reportable conditions (Not public emergencies):
Syphilis, Gonorrhea, Salmonella.
A
Within 1 week (7 days).
14
Q
How long must physicians store records?
A
7 years or until age of 21 if patient is a minor, whichever is longer.
15
Q
How long must hospitals store records?
A
10 years after the patient was last seen or until 20th birthday if patient is a minor, whichever is longer.
16
Q
How long do hospitals have to submit a bill?
A
30 days.
17
Q
How long do hospitals have to furnish medical records?
A
15 business days.
18
Q
How long does the physician’s malpractice insurer have to notify the board of any lawsuits or payments on malpractice claims?
A
30 days.
19
Q
How long do physicians have to appeal any decision made by the board regarding malpractice claims?
A
30 days.
20
Q
How often does your medical license need to be renewed?
A
Every 2 years.
21
Q
What is the fine for renewal of a medical license that expired less than 90 days ago?
A
$75.
22
Q
What is the fine for renewal of a medical license that has been expired for 91 - 364?
A
$150.
23
Q
What happens if your medical license has been expired for more than one year?
A
It is cancelled.
24
Q
When is a fine issued for late renewal fees for a medical license?
A
After greater than 30 days.
25
How long to physicians have to inform the board of practice information changes?
30 days.
26
When and where must physicians file an appeal for a revoked license?
Within 30 days in Travis Country.
27
How long does the physician's malpractice insurer have to notify the board regarding lawsuits or payments on malpractice claims?
30 days.
28
When must the board notify appropriate healthcare facilities of any physician's restrictions or suspensions?
On the first working day.
29
When does the board have to give written notification to appropriate parties?
30 days.
30
When and because of what convictions of a provider does DPS have to be notified?
Within 30 days.
| For: felony, Class A and B misdemeanor, Class C misdemeanor with moral implications, and a narcotic violation.
31
How long do physicians have to appeal decisions made by the board?
30 days.
32
How long is patient's grace period for finding another provider after the physician-patient relationship termination?
30 days.
| Continue treatment during this time.
33
When must a plaintiff file an intent to sue?
60 days prior to the lawsuit.
34
Statute limitation - from occurrence of breach for health care claims.
Duration?
2 year statute limitation.
Notice of intent to sue suspends the statute of limitations 75 days.
Real duration fo limitations - 2 years and 75 days.
35
Discovery rule exception.
The plaintiff must file a suit within 2 years of he/she discovering that the negligent act took place. Minors have two years after turning 18 to file suit.
36
When are all the parties entitled to the patient's medical records.
Within 45 days from the date of a written request.
37
When must the defendant file an objection with the court.
Within 21 days of being served.
38
When must the plaintiff file all liability and causation issues with the medical expert findings?
This is the expert report filed within 120 days of filing the claim.
39
When, where and by whom are birth reports filed?
Within 5 days.
By physician or hospital administrator.
With local registrar.
40
When does a certificate of death have to be filed?
Within 10 days.
41
How long can emergency detention for mental illness be?
Maximum period is 72 hours prior to probable cause hearing.
| And not longer than 90 days.
42
After emergency detention when must the physician examination occur?
Within 24 hours.
43
How long does a patient need to be observed for before indefinite commitment may occur?
At least 60 days.
44
When must the hearing after filing a petition for indefinite commitment?
Within a 14 day period from date of filing of petition.
45
When is DEA registration renewed?
Every 3 years.
46
Which drugs require triplicate forms and when is the form sent to DPS?
Schedule II drugs.
| Sent to DPS within 30 days.
47
How long does a physician have to report death from suspected neglect or abuse?
48 hours.
48
What is it?
Transferring a child for monetary gain.
3rd degree felony.
49
What is it?
Sexual abuse of a nursing home patient.
2nd degree felony.
50
What is it?
Fraudulently or maliciously makes a false report regarding the circumstance of child abuse.
Felony and fine of $1000.
51
What is it?
Manufacture of a dangerous drug.
Felony.
52
What is it?
Illegal sale of a dangerous drug.
Felony.
53
What is it?
Alter a birth certificate or knowingly make a false statement to deceive on one.
3rd degree felony.
54
What is it?
Practicing medicine without a license or a valid registration receipt in violation of the medical practice act.
3rd degree felony.
55
What is it?
Subsequent offences for violating the Texas Occupation code for receiving remuneration for referrals.
3rd degree felony.
56
What is it and under what code?
Physicians who accept any benefit from another person that unduly influences the care and treatment of a patient.
Felony.
Texas Penal Code.
57
What is it?
Promoting a suicide that results in death or serious injury.
Felony.
58
What is it?
Promoting a suicide that does not result in death or serious injury.
Class C misdemeanor.
59
What is it?
Purposely file a report in bad faith of nursing home abuse in the elderly or disabled,
Class A misdemeanor.
60
What is it?
Failure to report elderly abuse or neglect outside or inside the nursing home.
Class A misdemeanor.
61
What is it?
Possession of an illegal drug.
Class A misdemeanor.
62
What is it?
To operate a drug treatment program without a license from the Texas Department of Safety and Health Services,
Class A misdemeanor.
63
What is it?
A violation of the Texas, Food, Drug, and Cosmetic Act regarding the proper manufacture, sell, advertisement, distribution, and dispensing of medications to the public by a physician.
Class A misdemeanor.
64
What is it?
Testing for HIV without consent if exemptions are not present.
Class A misdemeanor.
65
What is it?
Physicians guilty of solicitation of patients who receive remuneration for referrals.
Class A misdemeanor and physician subject to civil penalty of no more than $10,000.
66
What is it?
Any offence under the section of the Texas Penal Code regarding record tampering.
Class A misdemeanor.
67
What is it?
A violation of the Medical Practice Act or Board decision.
Class A misdemeanor.
Can also lead to a fine of $5000.
68
What is it?
Unlawful disclosure to the board regarding a physician's practice unless it is done in good faith.
Class A misdemeanor.
69
What is it?
Intentional alteration of an advanced directive.
Class A misdemeanor.
70
What is it?
Intentionally disturbing or dissecting a human corpse.
Class A misdemeanor.
71
What is it?
Patient who ignores a court order or control measure to prevent the spread of a communication disease.
Class A misdemeanor.
72
What is it?
Purposely file a report in bad faith of abuse in an elderly or disabled person not in a nursing home.
Class B misdemeanor.
73
What is it?
Failure to report a case of child abuse to the local law enforcement agency and/or Department of Protective and Regulatory Services.
Class B misdemeanor.
74
What is it?
Failure to report or notify local health authorities of a reportable disease immediately for public health emergencies and otherwise for non-emergencies.
Class B misdemeanor.
75
What is it?
To falsely advertise DMSO or distribute a non-sterile or unapproved form of DMSO.
Class B misdemeanor.
76
What is it?
Fraudulent registration or use of a suspended DPS registration.
Class B misdemeanor.
77
What is it?
Performing an autopsy without proper consent.
Class B misdemeanor.
78
What is it?
Using a DEA number for illegal purpose.
Class C misdemeanor.
79
What is it?
Failure to report sexual relations between a consenting mental health patient and their provider.
Class C misdemeanor.
80
What is it?
Failure to comply with state regulations regarding the proper documentation for birth and death certifications.
Class C misdemeanor.
81
Consequences of improper disclosure of HIV results without written consent or exemption under Texas law.
Liability for civil action for actual damages done to the patient.
Liability for court costs and legals fees.
A fine up to $5000 for negligent disclosure.
A fine from $5000 - $10,000 for malicious disclosure.
82
Consequences of violating the Anti-Kickback law.
Exclusion from any federal health care program.
Civil fine up to $50,000 for each act and damages of no more than three times the remuneration amount.
Felony conviction.
Criminal penalty of 5 years in prison and/or a fine up to $25,000.
83
What is it?
The Texas Occupations Code's prohibition and penalty regarding the solicitation of patients for payback.
First offense: Class A misdemeanor.
Subsequent offense: 3rd degree felony.
Civil penalty of up to $10,000 for each act of violation.
84
Consequences of violation of EMTALA.
Penalties against hospital and physician: fine of no more than $50,000 and each are subject to termination of of provider agreement with Centers for Medicare and Medicaid Services.
The hospital is subject to civil liability and damages.
85
Texas Civil Practice and Remedies Code.
Non-economic damages cap: $250,000 per claimant.
Exemplary damages for wrongful death may not exceed $500,000 for each claimant regardless of number of defendants or hospitals.
86
Tort reform (2003) for limitations on exemplary damages.
Limited to the greater of twice the economic damages plus an amount equal to any non-economic damages, not to exceed $750,000; or $200,000.
87
HIPAA Privacy Rule: Civil and criminal penalties for unlawful disclosure.
Civil: Up to $100 per violation or up to $25,000 per person per year for each violation.
Criminal: Up to $50,000 and one year in prison for disclosing PHI or up to $250,000 and 10 years in prison with intent to sell.
88
Unlawful disclosure of substance abuse records - consequences.
First offense: $500
| Subsequent offenses: No more than $5000.
89
Consequences of wrongful handling or abuse or a corpse.
$4000 fine and/or jail term up to 1 year.
90
What is it and consequences?
Failure to report a gunshot wound.
Misdemeanor.
Imprisonment up to 6 months and/or fine up to $100.
91
According to the Texas Occupations Code when can a physician in an urban area supply drugs?
May supply any drugs or supplies to meet a patient's immediate needs.
May also supply pharmaceutical samples to a patient free of charge which adheres to a course of treatment,
The free samples may be given as long as they are properly, labeled, un-tampered, and free of charge.
92
Physicians in rural areas can do what in addition to supplying drugs according to the Texas Occupations Code in comparison with doctors in urban areas?
May dispense dangerous drugs when there is no pharmacy, and may even be reimbursed for the cost of supply without obtaining a license to practice pharmacy.
93
Texas Administrative Code - amendment/correction to medical record.
Mark or identify the error by drawing one line through the error, initial and date it, and then clearly identify the correction or amendment.
94
When can you advertise yourself as board certified?
Only if the specialty board that conferred the certification and the certifying organization is a member board of the American Board of Medical specialties or the Bureau of Osteopathic Specialists, or of the American Board of Oral and Maxillofacial surgery.
95
What are you not allowed to do on advertisements?
Materially misrepresent the cost or character of the medical service for the purpose of selling it.
Cannot advertise a product not subject to verification.
Cannot advertise professional superiority over another physician.
Cannot contain a testimonial.
Cannot say a service is free when it is not (even if insurance company pays),
Cannot waive co-payments or deductibles.
Cannot write 'board eligible' and if you wrote 'board-certified' must be followed by board certified in what.
96
What do you need to produce, use or transfer radioactive materials?
A special permit or license.
97
When can you treat worker's compensation patients?
The initial exam can be done by anyone if there is an acute medical problem. To treat them you need to be approved by the Texas Department of Insurance.
98
What are the rules for abortion in Texas?
Third abortions of viable unborn children are not permitted except if the physcian concludes in good faith that the abortion is necessary to prevent the death of the mother, or is substantial risk of serious impairment to the physical or mental health of the mother, or if the fetus has a severe and irreversible abnormality as identified through reliable diagnostic procedures.
99
Who may organize a professional liability LLC?
Doctors and podiatrists.
100
Who may organize an LLC or partnership?
Doctors and optometrists.
101
Who may form professional associations, corporations, or LLC?
Professionals, other than physicians, engaged in related mental health fields, such as psychology, professional counseling, or social work.
102
Who may physicians not join business entities with?
Mental health professionals.
103
Are business partnerships between a physician and a non-physician allowed?
No.
| Even if the non-physician is the spouse.
104
Can non-profit organizations be owned by non-physicians?
Yes.
105
What is an Health Maintenance Organization (HMO)?
Doctors and hospitals that join to provide health care for a comprehensive predetermined fixed fee.
106
What is a Preferred Provider Organizer (PPO)?
An organization of physicians who provide care for patients covered by traditional insurance plans at reduced cost, with employees and their insurance companies retaining most of the financial risk.
107
In which cases can money be involved in transferring a child?
Fee paid to child-placing agency.
Fee paid to an attorney or physician for services rendered in the usual course of legal or medical practice.
Reimbursement of legal or medical expenses incurred by a person for the benefit of the child.
Necessary pregnancy-related expense paid by child-placing agency.
108
Who may not perform an exposure prone procedure?
Health care workers who are infected with HIV or Hepatitis B and are HBeAg positive.
109
Renewal policy if license has been cancelled.
Cancelled after 1 year.
1 - 2 years = the physician must reapply as if getting a new license. The board may reissue a new license to a person whose license was automatically cancelled without examination if it was less than 2 years.
> 3 years = physician must apply for a new license and take the JP exam again.
110
The Board, on determining that a person committed an act described in the unlawful practices and penalties section of the Texas Occupation Code can enter...
Order to administer a public reprimand, deny a license, revoke a license, suspend a license, administer a penalty, or require you to submit to care or treatment.
111
How can you practice telemedicine in Texas?
A special purpose license exists for telemetry. These physicians must have a state license in good standing in the state in which they practice, be certified in a medical specialty approved by the American Board of Medical Specialties, passed the Texas Jurisprudence Exam, and the physician cannot physically practice medicine in the state of Texas.
112
What kind of disciplinary actions are confidential?
Non-Disciplinary Rehabilitation Orders.
113
Which of the following circumstances allows the Board to issue a confidential rehabilitation order?
Self-reported use of drugs or alcohol.
Judged to be of unsound mind.
Findings of physical or mental impairment.
Discovery that the provider suffers from a potentially dangerous limitation.
114
What's the single major cause of lost malpractice lawsuits?
Inappropriate and inadequate medical record keeping.
115
How long do medical records relating to civil or criminal proceeding need to be kept?
Until the proceedings have resolved.
116
Medical records must be supplied how long after a written request is received?
15 business days.
117
How to deny request for medical records?
Physician must notify the patient in writing within 15 business days of the reason for denial.
118
In peer review meetings if there is restriction of clinical privileges for longer than 30 days then...
This must be reported to the Board.
119
What must a termination of patient-physician relationship have?
Written notification to patient by return receipt mail.
Statement of reason for termination.
Clear statement of termination date.
Allowance of 30 day grace period for continual treatment until care is transferred to another physician.
Provision of sources to assist patient in finding another physician.
Offer to transfer the patient's records.
120
Which prescriptions can physician assistants write?
For Schedule III - V drugs.
121
Which prescriptions can physician assistants not write?
For Schedule II drugs (requires triplicate); Schedule I drugs (no medical use).
122
Pharmacists can dispense generic drugs unless...
Dispense as written is checked.
123
Who can bill for assisting a physician in surgery?
A licensed surgical assistant.
124
What is required to start school unless you have an affidavit?
Immunization.
125
In cases of family violence and domestic abuse (not elderly or child) what should you do?
Document findings in the chart.
Offer to contact local authorities.
Provide information about nearby shelters to abused spouse.
126
When can the board suspend your license?
The Board shall revoke, suspend, or a deny a physician's license if the Board determines that, through the practice of medicine, the physician poses a continuing threat to public welfare.
127
When and who should be notified of any convictions?
The Texas Medical Board and DPS must be notified within 30 days for the conviction, or deferred adjudication verdict of a provider for any felony, Class A or B misdemeanor, or Class C misdemeanor involving moral turpitude, fraud or abuse under the Medicare or Medicaid program, and narcotic violations.
Do not wait till the time for renewal of your medical license to report a conviction listed above.
128
When do you report a Class B misdemeanor because of a DWI?
At the time of license renewal.
129
When do you report a Class B misdemeanor because of a DWI with an association of moral turpitude?
Within 30 days of being convicted.
130
What is the order of priority for medical decisions?
1. Patient's spouse.
2. Adult child who has the waiver and consent of other qualified adult children.
3. Majority of the patient's reasonably available adult children.
4. Patient's parents.
5. An individual clearly identified to act for the patient by the patient before he or she became incapacitated.
131
Texas Anatomical Gift law - who may donate organs?
Any individual above age 18 who has testamentary capacity may donate all or any part of his/her body.
Under 18 - may have it written on his/her driver's license but still needs approval of person's parents or legal guardian.
132
Patient in coma and not identified on driver's license - then who makes decision?
```
The order of priority executing a gift if unknown is the decedent's spouse, then adult children, then either parent, and finally adult brother or sister.
There must also not be any opposition by a member of a higher or same priority class that objects to the donation.
```
133
What conditions does a physician need to pay for lab or pathology services?
He discloses the name and address of the laboratory on the bill and the net amount paid to the laboratory.
134
Conditions for voluntary psychiatric admissions.
Facility administrator or his/her authorized designee may admit a person for whom a proper request for voluntary inpatient services is filed if:
1. a preliminary examination that the person has symptoms of mental illness and will benefit from the inpatient services.
2. the person has been informed of the person's right as a voluntary patient.
3. Admission was voluntary agreed to: by person 16 years or older, person younger than 16 who is or has been married, by the parent, managing conservator, or guardian of the person is younger than 16 years of age and has not been married.
135
How much time does a physician have to conduct a physical examination for voluntary admissions?
72 hours.
136
How much time does a physician have to conduct a physical examination for involuntary admissions?
12 hours.
137
Physician's authority to delegate the carrying out or signing of a prescription drug order is limited to:
4 physicians assistants or advanced practice nurses or their full-time equivalents practicing at the physician's primary practice site or at an alternative practice site under Section 157.0541 unless a waiver is submitted.
138
Duties of a physician in regard to communicable diseases.
Physician shall report it to the local Health Department or to the Department of State Health Resources.
Instruct patient in measures for preventing spread of disease.
Does not include a duty to inform and educate the spouse and other people who are in close contact.
139
When does a non-professional make a report of child abuse?
Immediately after he/she has cause to believe the child's mental/physical well being has been affected by abuse.
140
When does a professional (physician) make a report of child abuse?
No later than the 48th hour after abuse has been suspected.
141
How many days does the physician have to report any complaint or malpractice suit if he/she does not possess medical liability insurance?
30 days.
142
Newborn screening.
Parents approval needed: PKU and hypothyroidism. If parents object on religious grounds then the physician shall not be held liable.
143
Can professionals other than physicians, engaged inn related mental health fields such as psychology, clinical social work, licensed professional counseling, and licensed marriage and family therapy may form a professional entity that is jointly owned by those practitioners to perform professional services that fall within the scope of practice of those practitioners.
Yes.
144
Can prescriptions written by PAs have refills and what is the period of the prescription?
Yes.
| 90 days.
145
Primary practice site also includes...
| Alternate site
Any location where a PA/APN who practices on-site with the physician more than 50% of the time and provides:
1. health care services for established patients.
2. voluntary/charity services by non-profit or declared emergency/disaster.
146
Distance to alternate site.
Up to 75 miles from primary practice site or physician's residence.
147
Physician requirement for on-site supervision at alternate practice sites?
10%.
148
How many charts need to be reviewed at alteration practice sites?
Delegating physician needs to review at least 10% charts for each PA/APN. Electronic review of charts from a remote location is allowed.
149
Before delegating prescriptive authority to PAs or APNs they must be...
Registered with TMB.
150
How many PA/APNs can a physician delegate prescriptive authority to with a waiver and where are waivers allowed?
Waivers are allowed at primary and alternate practice sites.
The board may not allow a physician to delegate prescriptive authority to more than a total of 6 PAs or APNs (or their full-time equivalents).
151
When is the Board required to remove any record of a formal complaint filed at the State Office of Administrative Hearings?
When the complaint was dismissed more than 5 years before the date of the update and:
1. the complaint was dismissed as baseless, unfounded or not supported by the evidence; or
2. no action was taken against the physician's license as a result of the complaint.
152
When is the board required to remove any record of investigation of medical malpractice claims or complaints (3 suits in 5 years)?
1. The investigation was resolved more than 5 years before the date of the update; and
2. No action was taken on the physician's license as a result of the investigation.
153
What does the Texas Medical Board do?
Governs an regulates the practice of medicine set forth in the MPA.
154
How many members does the Texas Medical Board have?
Total 19 members, out of which 12 are physicians; each appointed by the Governor for 6 year terms.
155
What can the Texas Medical Board not do?
Cannot reissue a licence suspended after a felony conviction under the Texas Controlled Substance Act.
156
When are you eligible for a Texas Medical License?
Over 21 years of age.
Completed 60 hours of college other than medical school.
One year of graduate training.
Passed the Texas Medical Jurisprudence Exam.
Licencing exam (USMLE) within 7 years.
Foreign Grads: Additional requirements or 5th pathway.
157
What makes you ineligible for a license?
1. Restricted or suspended license from another state.
2. Under investigation for restriction/suspension.
3. Under investigation for a felony.
If indicted on a felony then the license is suspended pending investigation.
158
When do you need to apply for a physician-in-training permit?
90 days before training starts. Applies to residents.
159
How are podiatry patients admitted to the hospital?
They need to be co-admitted with another physician, especially if they have congestive heart failure or diabetes.
160
When can health care providers infected with HIV and hepatitis B/HbeAg perform exposure prone procedures?
After seeking counsel with expert review panel, the hospital develops guidelines and the physician notifies and obtains the patient's consent.
161
Telemedicine: Special purpose license - do they need to have passed the Texas Medical Jurisprudence Exam?
Yes they do.
| And their license must be in good standing in the State they practice in.
162
When do you not need a special purpose license to practice telemedicine?
1. Physician licensed in Texas gets an opinion from another physician in another state of the same specialty.
2. Physician in state contiguous to Texas (Louisiana, Oklahoma, Arkansas, New Mexico) who is the treating physician and orders home health or hospice services.
3. Physician in another state who provides medical consultations to a medical school or another educational institution.
163
How do you get on the approved doctors list for worker's compensation?
Apply to Texas Department of Insurance to get on the list.
164
How much CME does the board require?
24 hours.
12 hours have to be formal.
1 hour has to be medical ethics.
165
Do you have to inform the board that you don't have malpractice insurance?
No.
166
What if you have a suspension or criminal sanction in another state or in the military?
The TMB has a duty to report it.
167
When does the Board review the license like a complaint?
3 lawsuits in 5 years.
168
Non-economic damages: physical pain and suffering.
Max $250,000 per claimant.
If multiple hospitals/institutions then $500,000 ($250,000 max for each).
Wrongful death: $500,000.
169
Stower's Doctrine.
Liability insurance company lawyers have to represent the physician with the same care and thoroughness as they are with representing their own business (insurance company).
170
Who's liable for negligence?
All the parties are responsible for judgement. They can sue each other for their share.
171
Is Texas a Tarosoff staff?
No.
172
When you have to forward medical requests?
Within 15 business days of written request.
173
Reason for not releasing medical record?
Damaging to patient.
174
How do you write a triplicate prescription?
No refills.
| Quantity prescribed followed by number written down in letters.
175
When can your DEA registration be suspended?
Failure to maintain records.
Fraudulent information.
Suspended license.
Convicted of felony.
Failure to maintain effective controls against diversion.
Suspended controlled substances registration.
176
What kind of drugs are anabolic steriods?
Schedule III.
| Must carry caption, :'Federal law prohibits use without a prescription'.
177
When are pharmaceuticals free to a patient?
Left in company package and not repackaged by physician.
Physicians keep records of the sample.
Applies to rural and urban physicians.
178
Difference between rural and urban environment in dispensing samples.
Rural (no pharmacy within 15 miles, population < 2500 (town) or < 5000 (county) - can charge.
Urban - cannot charge.
179
Intractable pain and treatment act.
Protects physicians for prescribing narcotics for generally accepted medical conditions.
180
How much medication can a pharmacist dispense without provider approval?
72 hours supply.
181
What does D.P.M. stand for?.
Doctor of Podiatric Medicine.
182
D.D.S.
Doctor of Dental Surgery.
183
D.D.M.
Doctor of Dental Medicine.
184
O.D.
Doctor of Optometry.
185
D.S.C.
Doctor of Surgical Chiropody.
186
D.C.
Doctor of Chiropratic.
187
What can the Board not restrict regarding advertisements?
```
Duration.
Medium.
Length.
Use of voice.
Size.
Use of trade name.
```
188
Should be able to provide written proof of being board certified on the day the advertisement is placed.
True.
189
Advertising cost possible?
Only if the cost is not deceptive.
190
Is the net amount paid to the laboratory available to the patient?
Yes. On written request by patient or third party payers.
191
When is a physician required to accept a patient?
Only in an emergency.
192
PA Advisory Council overseen by board. How many members?
9.
193
How many PAs can a physician have normally.
5.
194
For PAs what must physicians do in regards to patient care.
Review the histories and physicals.
195
What are the requirements for supervision in medical under-served areas?
Must receive daily report.
Visit every ten business days.
Available by phone consultation.
Responsible for standing orders or protocols.
196
Respondeat Superior...
Physician is responsible for the actions of his/her employees.
A hospital is liable for the nurses/staff in the hospital.
Hospital is generally not responsible for their physicians negligence.
197
Good Samaritan Law.
Protects physicians from liability at the scene of emergencies.
Exceptions: gross negligence; charging a fee, if there was a pre-existing duty to treat or were responsible for the emergency.
Emergency physicians have to practice within standard of care in the ER in emergencies.
198
EMTALA.
| Emergency Medical Treatment and Active Labor Act.
Must provide emergency screenings.
Screening to not have to be a physician.
They have to provide treatment for emergent conditions and active labor.
Do this regardless of ability to pay.
If cannot provide treatment (no capability) then transfer to higher level of care.
199
When can unstable patients be transferred?
Patient requests transfer and understands the risks.
| Physician must sign a written summary that benefits exceed risks.
200
Can a receiving hospital refuse admission of a transfer from an under-equipped facility?
No.
201
What is?
EMTALA violation - Reckless.
Class B misdemeanor.
| Escalates to Class A if death or permanent injury results.
202
What is?
EMTALA violation - Intentional
Class A misdemeanor.
| Escalates to 3rd degree felony if death or permanent injury results.
203
EMTALA violation - consequences.
Physician/hospital - fined $50,000.
Physician/hospital - subject to provider termination agreement (Medicaid/Medicare)
Hospitals - Civil liability.
Hospital < 100 beds - fine $25,000.
204
Tort of battery.
Unwanted touching of patient.
205
Reasonable patient standard of informed consent.
What a reasonable patient would want to know in making an informed decision about a procedure.
206
Implied consent doctrine.
Emergency situations - consent not available.
207
List A procedures.
Procedures that require full consent.
208
What is the basis for recovery for informed consent?
Negligence in failure to disclose the risks and benefits.
209
Blood sample from a drunk person.
Implied consent for specimen of blood is presumed. A licensed provider has to take the blood.
210
When can children consent without parent notifcation?
Active duty in military.
Above 16 years, live separately and manage their own financial affairs.
Diagnosing or treating infectious or communicable disease.
Pregnant women (unmarried) - except abortions.
Sexual abuse, drug and chemical dependence or suicide prevention treatment.
211
Removal of Disabilities by Minors by the Court.
Texas resident.
17 years old or 16 and separated from parents.
Managing their own affairs.
212
Order of consent for minors.
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Natural mother.
Natural father.
Adoptive mother or father.
Parent/guardian.
Adult sibling/grandparents/adult uncle or aunt.
Adult with written authorization.
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213
Surrogate decision maker - order.
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Spouse.
Adult children - consent of other adult children.
Majority decision of available children.
Parents.
Individual with power of attorney.
Nearest living relative.
Member of clergy.
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Advanced directive trumps everything.
214
What can the surrogate decision maker not do?
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ElectroConvulsive Therapy.
Psychosurgery.
Abortion.
Appointment of another surrogate.
Voluntary mental services (inpatient).
With-holding of life sustaining treatment.
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215
Can pregnant patients have life sustaining treatments with-held?
No.
216
Who cannot be a power of attorney?
Treating physician.
Employee of treating physician.
Residential care provider of the patient.
Employee of the patient's residence.
217
What needs to be administered to pregnant women at the first pregnancy visit and at birth?
Blood testing for HIV, Syphilis and Hepatitis B.
| Provide information about treatment if the test is positive.
218
When can a minor have an abortion?
Parents notified and give written consent.
Minor has a court order.
To prevent serious injury to the minor.
219
What should you do for newborns?
PKU, hypothyroidism, HIV, sickle cell, other inheritable diseases.
Hearing exam offered.
Eye prophylaxis drops to prevent ophthalmia neonatorum.
220
Who files the birth report if born outside hospital?
Parents.
221
Wrongful pregnancy.
Ineffective sterilization resulted in pregnancy.
222
Wrongful birth.
Delivery of child with defects because physician did not provide genetic counselling so mother missed opportunity for abortion.
223
Post-conception torts.
Injuries incurred during delivery.
224
When do you hold an inquest for a death?
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Suspicious circumstances.
Unnatural death.
No witnesses.
Suicide.
Dies in jail.
Murder.
Result of abuse.
Die within 24 hours of hospital admission.
```
225
When are autopsies performed?
When ordered by medical examiner or justice of the peace, or under valid consent.
226
Duty to report what kind of conditions?
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Elderly (older than 65 years) or disabled abuse.
Nursing home patient abuse/neglect.
Child abuse.
Abuse or inappropriate conduct with mental health patients.
Drug overdose: If it is Penalty group 1 drug.
Gunshot wounds.
Spinal cord injuries.
Birth defects.
Physician assistants who pose a threat.
Lead poisoning in children.
Sexually transmitted disease.
Communicable diseases.
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227
Illegal remuneration act
Forbids kickbacks to mental health institutions.
228
Corporate Practice of Medicine.
Forbids businesses owned by non-physicians to profit from the practice of medicine.
229
Sole proprietership.
Personal liability.
| Physician owned.
230
Partnership.
Generally personal liability.
| Physician owned.
231
Professional Association.
Limited liability.
| Taxed as a corporation.
232
Nonprofit Corporation.
May be owned by physicians and non-physicians together.
233
Who may incorporate under the Texas Professional Act?
Dentists and physical therapists.
| Physicians can not.
234
LLC
| Limited Liability Corporation.
Subject to Texas Franchise Tax (disadvantage).
Member's liability limited to capital contribution.
Tax advantages same as partnership/corporate.
235
Texas Worker's Compensation - no-fault statutory system.
Employee and employer both cannot sue.
236
Stark law.
Prohibits referrals of Medicare patients for designated services reimbursed under CMS to which physician has financial relationship.
