Module 4 - Compliance Requirements Flashcards

1
Q

What does HIPAA stand for

A

Health Insurance Portability and Accountability Act

It just also includes privacy, security, etc.

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

What are the three major areas addressed in HIPAA?

A
  1. Use and Disclosure of PHI/IIHI
  2. Patient Rights to PHI/IIHI
  3. Security in Administrative and Physical PHI/IIHI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What do PHI and IIHI stand for?

A

PHI = Protected Health Information

IIHI = Individual Identifiable Health Information

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

What does ARRA stand for?

A

American Recovery and Reinvestment Act

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

What does the ARRA (American Recovery and Reinvestment Act) provide?

A
  1. Regulates changes to HIPAA
  2. Enforces changes in HIPAA
  3. Provisions to address health information held by entities not covered by HIPAA
  4. Misc: Administration, Studies, Reports, Educational Initiatives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a Breach in PHI

A

Unauthorized access to or use of PHI

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

Covered Entity

A

Health Care business that maintain or transfer PHI electronically

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

Indirect Treatment Relationship

A

Patient/Provider relationship based on the orders of another Health Care Provider

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

Direct Treatment Relationship

A

Patient/Provider Relationship that’s not indirect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Minimum Necessary (Minimum Disclosure)

A

What PHI is absolutely necessary to share

Not applicable if patient has requested otherwise (whole chart, etc.)

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

Patient Rights

A

Patients have rights to their PHI/IIHI and records of PHI/IIHI transfers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Business Associates

A

Any organization or entity that provides a service involving PHI/IIHI

I.E. Insurance companies, Holland Hospital, etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Training (PHI training requirements)

A

Covered entity must train all workers on PHI policy/procedures

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

Administrative Safeguards

A

Managing Policy/Procedures and Workforce Conduct in regards to PHI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Insurance Fraud

A

Intentional Deception of insurance for the benefit of a patient (self or other)

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

Insurance Abuse

A

Insurance practices that either directly or indirectly result in unnecessary cost to (Medicare)

Cannot be proven to be intentional

17
Q

Civil Monetary Penalties (CMP)

A

Penalties imposed on person or entity who have violated (Medicare) rules/regulations

Up to $10,000 per violation

18
Q

What does OIG stand for?

What does just OI stand for?

A

OIG = Office of the Inspector General

OI = Office of Investigations

19
Q

Stark Violations

A

Physicians referring patient to services which they(or family member) have financial interest

20
Q

What does OSHA stand for?

A

Occupational Safety and Health Act