Legal Issues/ Ethics Flashcards
What topics are included under Legal Issues / Ethics according to the NBEO website?
- Licensure and governmental regulation of optometry
- Standards of professional ethics
- Doctor-patient relationship
- Professional liability
These topics are essential for understanding legal and ethical considerations in optometry.
What does the Federal Patient’s Bill of Rights state about patient provider choice?
Patients should be able to choose their providers to guarantee quality healthcare.
This right emphasizes the importance of patient autonomy in healthcare.
What information must patients receive according to the Federal Patient’s Bill of Rights?
Accurate, easily understood information to make informed healthcare decisions.
This ensures that patients are well-informed about their healthcare options.
What right do patients have regarding decisions about their healthcare?
Patients have the right to actively participate in decisions regarding their healthcare.
This right reinforces the collaborative nature of the doctor-patient relationship.
Who can represent a patient in healthcare decisions if they are unable to do so?
Family or a guardian.
This provision protects the rights of patients who cannot make decisions for themselves.
What confidentiality law must healthcare providers follow according to the Federal Patient’s Bill of Rights?
HIPAA
HIPAA stands for the Health Insurance Portability and Accountability Act, which protects patients’ identifiable health information.
What is required of patients concerning payment for their medical care?
Patients are required to make a good faith effort to pay for their medical care.
This requirement emphasizes the shared responsibility in the healthcare system.
What are the requirements of informed consent for healthcare providers?
- Explain the diagnosis/problem
- Explain treatment management
- Describe possible risks and benefits
- Describe alternative treatment options
These steps ensure that patients understand their treatment options and the associated risks.
Who can give consent for a patient who cannot make informed decisions?
A surrogate or guardian.
This is crucial for patients who are children or lack mental capacity.
What must optometrists do regarding spectacle prescriptions?
Release a spectacle prescription to the patient, regardless of changes.
This ensures patient access to their prescription information.
What is the ethical stance regarding comments about colleagues?
It is not ethical to make derogatory comments about your colleagues.
Who owns patient records according to optometry standards?
Doctors have ownership of patient records; patients do not own their medical records.
What rights do patients have regarding their medical records?
Patients have the right to view and obtain copies of their medical records.
Under what conditions can doctors withhold patient records?
Doctors can withhold release of records until the patient initiates some payment for services rendered.
What is the ownership status of patient records when a doctor leaves a practice?
All partners in a practice have joint legal ownership; independent contractors own records only for managed patients.
Do employees have any legal ownership of patient records?
No, employees have no legal ownership to any of the patient records.
What is the responsibility of an optometrist regarding staff training?
Optometrists must train staff to properly triage phone calls.
What are the consequences if a staff member fails to schedule an emergent appointment?
The doctor is responsible if the patient loses vision or dies before their appointment.
Define Autonomy in the context of patient rights.
Patients have a right to make their own decisions.
What does Beneficence mean?
Helping others; it relates to the benefit others receive from help.
What is the Good Samaritan Law?
It protects individuals providing emergency healthcare from liability for poor outcomes.
Define Justice in a healthcare context.
Equal treatment of similar cases and fair distribution of goods and services.
What is the Medical Tribunal System?
A system that decides if a claim has merit to proceed as a lawsuit.
What does Nonmaleficence mean?
Providers should ‘do no harm.’
What are Punitive Damages?
Fines/Damages designed to punish an optometrist for terrible patient care.
What is the Statute of Limitations?
The maximum time parties have to initiate legal action.
What is Tort Reform?
Caps/limits on the fines/damages awarded during lawsuits.
What is the primary purpose of HIPAA?
To preserve the patient’s right to privacy
HIPAA stands for the Health Insurance Portability and Accountability Act.
List three examples of patient identifiers protected by HIPAA.
- Patient’s Name
- Social Security Number
- Medical Record Number
True or False: HIPAA applies to all individuals and organizations.
False
HIPAA only applies to Health Care Providers, Plans, and Clearinghouses.
Under what condition can providers share medical information with a patient’s friends and family?
With the patient’s consent
How long must a contact lens prescription be valid for at a minimum?
At least one year
Unless there is a medical indication for a sooner expiration date.
Who can prescribe contact lenses?
- Optometrists
- Ophthalmologists
- Opticians
Fill in the blank: A contact lens prescription must be released to the patient after the _______ is completed.
[fitting]
What is required of a third-party seller of contact lenses regarding prescription verification?
They must verify the contact lens prescription.
How long does an optometrist have to verify a contact lens prescription once contacted?
8 business hours
What happens if an optometrist does not respond to a prescription verification request within 8 hours?
It is considered ‘passive verification’ and the third party seller can fill the prescription.
True or False: The optometrist needs permission from the patient to release medical information for contact lens prescription verification.
False
Name two exceptions to HIPAA.
- Sharing medical information with the patient’s consent
- Reporting an epidemic to a government agency
List five patient identifiers as defined by HIPAA.
- Email Address
- Phone Number
- Vehicle Identifiers
- Date of Birth
- Biometric Identifiers
What is the Stark Law regarding optometrists?
Optometrists are prohibited from referring a Medicare/Medicaid patient to a doctor who is their family or with whom they have a financial relationship.
The law is designed to prevent conflicts of interest in medical referrals.
What should an optometrist know when making a referral?
The specialist they refer the patient to is competent to treat the patient.
Competence ensures that the patient receives appropriate care.
What information should an optometrist provide when making a referral?
The patient’s medical history information.
This is crucial for the specialist to understand the patient’s background and needs.
Is it legal for optometrists to receive kickbacks for referrals?
No, it is illegal for optometrists to receive kickbacks/money for making a referral in many states.
This regulation helps prevent unethical practices in healthcare.
Are specialists required to send patients back to the referring optometrist?
No, specialists are allowed to steal patients from the referring optometrist.
This can create competition among healthcare providers.
What is the responsibility of optometrists after making a referral?
Optometrists are NOT responsible for the patient’s treatment after they have made the referral.
This delineates the boundary of care responsibilities.
What is the purpose of Antitrust Laws?
To maintain the free market economy and thereby protect consumers.
These laws prevent monopolistic practices and promote competition.
Can optometrists engage in price-fixing?
No, optometrists are not allowed to engage in price-fixing by collaborating to set their fees.
Each office must independently set their own fees to ensure fair competition.
What is prohibited regarding suppliers or businesses?
Optometrists cannot join forces to boycott a specific supplier or business.
This rule is in place to prevent anti-competitive behavior.
What does HIPAA stand for?
Health Insurance Portability and Accountability Act
What is the primary purpose of HIPAA?
To protect patient’s health information and regulate its use and disclosure
What does HIPAA ensure regarding health information flow?
Continued ease of health information flow between healthcare practitioners and institutions
What is ‘individually identifiable health information’?
Information that relates to an individual’s health or healthcare and can identify the individual
List three aspects that individually identifiable health information relates to.
- Past, present, or future physical or mental health or condition
- Provision of health care to the individual
- Payment for the provision of health care
What are some examples of individual identifiers under HIPAA?
- Full name (or last name and initial)
- Address
- Birth date
- Social Security number
- Phone number
- Email addresses
- Medical record numbers
- Vehicle identifiers
- Account numbers
True or False: The Privacy Rule includes employment records maintained by a covered entity.
False
What type of records are excluded from protected health information under HIPAA?
Employment records maintained in capacity as an employer and certain education records
Fill in the blank: HIPAA was created to protect _______.
patient’s health information
What is the Family Educational Rights and Privacy Act related to in the context of HIPAA?
It defines certain records that are excluded from protected health information
Define patient autonomy in the context of optometry.
The right of patients to make informed decisions about their own care
This term emphasizes the importance of respecting patients’ choices.
What does non-maleficence refer to?
The duty of an optometrist to avoid acts that could potentially harm a patient
This principle is often summarized as ‘do no harm.’
What does beneficence mean in the profession of optometry?
‘Do good’ and proactively serve the needs of the patient and the public
This includes addressing eye, vision, and overall general health.
What duty do optometrists have towards patients, colleagues, and society according to the AOA?
To treat them fairly and without prejudice
This concept is referred to as ‘justice.’
What is the NPI?
National provider identifier
* identification number for health care providers issued by CMS for billing
What is the purpose of HIPAA?
HIPAA is designed to preserve the patient’s right to privacy.
HIPAA stands for the Health Insurance Portability and Accountability Act.
What must a provider do to disclose medical information freely?
Remove all the patient’s identifying information.
This includes various identifiers that make a patient identifiable.
List three identifiers included in Protected Health Information (PHI).
- Patient’s Name
- Social Security Number
- Email Address
There are a total of 18 identifiers included in PHI.
To whom does HIPAA apply?
Health Care Providers, Plans, and Clearinghouses.
HIPAA regulates how these entities handle patient information.
True or False: Providers can share medical information without patient consent in all situations.
False.
Providers need patient consent to share information with friends and family.
What must a contact lens prescription be released to the patient after?
After the fitting is completed.
This requirement ensures patients have access to their prescriptions.
How long must a contact lens prescription be valid at minimum?
At least one year unless there is a medical indication for a sooner expiration date.
This ensures that patients can use their prescriptions for a reasonable period.
Who can prescribe contact lenses?
- Optometrists
- Ophthalmologists
- Opticians
The ability to prescribe may vary depending on state laws.
What is required of a third party seller of contact lenses regarding prescriptions?
They are required to verify the contact lens prescription.
This adds a layer of safety and ensures compliance with regulations.
What happens if an optometrist does not respond to a prescription verification request within 8 hours?
It is considered ‘passive verification’ and the third party seller can fill the contact lens prescription.
This rule facilitates timely access to contact lenses for patients.
Regarding HIPAA, what is required for the verification of a contact lens prescription?
The verification is required for treatment, so the optometrist does not need to get permission from the patient to release this medical information.
This highlights the importance of treatment-related disclosures.
