Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MA Exam > Law, Ethics, and HIPAA > Flashcards

Law, Ethics, and HIPAA Flashcards

1
Q

licensure

A

strongest form of administrative regulation; needed to practice medicine

  • granted by state board
  • verifies that person holding license has met minimum standards
  • must be periodically renewed
  • granted by examination, endorsement, reciprocity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Clinical Laboratory Improvement Act of 1988 (CLIA 1988)

A

identifies standards for laboratory testing; any facility performing lab testing subject to CLIA 1988

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Certificate of Need (CON)

A

certificate needed to expand service and get approval to expand service (based on need to community)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The Joint Commission (TJC)

A

accreditation of healthcare facilities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

OSHA (Occupational Safety and Health Administration)

A

regulates safety in workplace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ADA (Americans with Disabilities Act)

A

sets up rules protecting people with physical or mental disabilities from discrimination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Title VII (7) of Civil Rights Act

A

protects employees from sexual harassment and hostile work environment; employer is liable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Federal Discrimination Act

A

employers with 15+ employees cannot discriminate on basis of age, gender, sexual orientation, race, creed, marital status, color, national origin, disabilities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Regulation Z of the Consumer Protection Act

A
  • Truth in Lending Act
  • requires pt and provider to agree if payment of bills is to be made in more than 4 installments; agreement must be in writing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Controlled Substances Act

A
  • administered by DEA (Drug Enforcement Administration)

- regulates any individual who prescribes, administers, or dispenses controlled substances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

FMLA (Family Medical Leave Act)

A

employers with 50+ employees must provide up to 12 weeks of unpaid, job-protected leave each year

  • for care of employees own health
  • care of immediately family member with serious health condition
  • birth or adoption of child
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

HIPAA (Health Insurance Portability and Accountability Act)

A

requires privacy and security standards to protect patient’s identifiable health information

  • sets stds for privacy of individually identifiable health info
  • allows flow of health info while protecting pt’s privacy
  • failure to comply –> sanctions and fines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

risk management

A

techniques that keep practice, environment, and procedures as safe for pt as possible
- proper risk management decreases chance of negligence/lawsuits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

techniques of risk management

A
  1. only perform within scope of practice
  2. follow federal and state statutes
  3. keep office and clinic areas safe
  4. keep all pt info confidential
  5. follow all established office policies
  6. document completely
  7. log telephone calls and return calls in reasonable amt of time
  8. follow up on canceled/missed appts
  9. never guarantee cure or diagnosis; never advise without provider order
  10. secure informed consent
  11. explain apptment delays
  12. be aware of pt’s w/ special needs
  13. report any error to employer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

consent

A

voluntary permission given by capable person to receive medical care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

types of consent

A
  1. express (oral or written)

2. implied (actions or behavior that can be understood as consent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

informed consent consists of

A

allows pt to adequately evaluate medical care; understanding of
- what procedure is, why, risks, benefits, alternative treatments, risks of alternative treatments

18
Q

National Labor Relations Act of 1935 (NLRA)

A

defines unfair labor practices

- provides hearing or mediation of complaints

19
Q

FLSA (Fair Labor Standards Act of 1938)

A

defines minimum wage, equal pay for equal work, child labor restrictions
- req all employee records of hours worked to be continuously maintained

20
Q

Equal Pay Act of 1963 (EPA)

A

amendment of FLSA; addresses wage disparities based on sex

21
Q

Equal Employment Opportunities Act of 1972 (EEOA)

A

prohibits employment discrimination based on age, race, sex, color, religion, national origin

22
Q

ADEA (Age Discrimination in Employment Act of 1967)

A

prohibits discrimination based on age

23
Q

worker’s compensation law

A

state-mandated programs to provide wage continuation and medication treatment compensation for work-related injuries + illnesses

24
Q

two provisions of HIPAA

A
  1. Health Insurance Reform

2. Administrative Simplification

25
Q

Department of Health and Human Services (HHS)

A

establishes and implements standards

26
Q

CMS (Centers for Medicare and Medicaid)

A

enforces insurance portability and code set reqs of HIPAA

27
Q

OCR (Office of Civil Rights)

A

enforces privacy standards

28
Q

covered entity

A

can be healthcare plan (e.g. Blue Shield/Blue Cross), health care provider, healthcare clearinghouse

29
Q

transaction

A

transmission of information btwn 2 parties

  • health care claims
  • health care payments
  • coordination of benefits
  • claim status
  • enrollment and disenrollment in health care plan
  • eligibility for health plan
  • premium payments
  • referral certification or authorization
  • first report of injury
30
Q

privacy

A

being secluded from view or presence of others

31
Q

confidentiality

A

use of discretion in keeping info private

32
Q

disclosure

A

release, transfer, access to, or divulgence of info

33
Q

IIHI (individually identifiable health info)

A

any part of someone’ health information collected (e.g. DOB, demographic info)

34
Q

PHI (protected health info)

A

IIHI that is transmitted or maintained in any form or medium (electronic or otherwise)

  • all pt info is protected regardless of way it is maintained
  • includes paper records, billing system, spoken words, x-ray
35
Q

use of IIHI

A

sharing, application, use, examination, analysis of IIHI

36
Q

use of PHI

A

PHI protected both inside and outside of org unless use is specifically required or permitted

37
Q

pt rights under HIPAA

A
  1. right to notice of privacy practices
  2. request restrictions on certain uses/disclosures of PHI
  3. request confidential info
  4. access PHI
  5. request amendment of PHI
  6. receive accounting of disclosures of PHI
  7. organization and staff responsibilities
  8. code set regulations
  9. guidelines for HIPAA privacy compliance
38
Q

HITECH Act (Health Information Technology for Economic and Clinical Health Act)

A

contains specific incentives to speed up adoption of EHR systems

  • widens scope of privacy and security under HIPAA
  • increases potential for legal liability for noncompliance
  • provides for greater enforcement
  • pt of 2009 american recovery act
39
Q

3 main components of EHR

A
  1. use of EHR in meaningful manner (e.g. e-prescribing)
  2. use of EHR technology for electronic exchange of health info (therefore improving quality of care)
  3. use of EHR to submit clinical quality reports, diagnosis, procedure codes, etc.
40
Q

what does meaningful use of EHR mean?

A

using EHR tech in ways that can be measured in quality and quantity
- if meet requirements, can qualify for incentive payments

MA Exam (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions