Professional issues

Question 1

what is the key factor that makes a crime fraud instead of abuse?

Answer 1

intentinoality

Question 2

medicaicare feraud strike force

Question 3

exclusion statutue

Answer 3

-section of social security act spells out circumstances when certian entitites can be banned from federeal healthcare programs
-excluded people are banned from participating directly or indirectly
-any organization whcih uses medicare of medicare is banned from hiring or contracted exluded people

Question 4

safe harbor

Answer 4

legal provision in a statue ore regulation that provides protrection from legal liability when certain conditions are met

ex:
-in office ancially servies
-physicians can employ PTs in their office-argument being that is convenient for patients

Question 5

what does HIPAA initial consent signed by patient cover?

Answer 5

-tx: getting results, communicating in secure managmetn, shared between professionals
-health operations
-payment

everthing else requires special consent

Question 6

unrestricted pt acccess

Answer 6

-no limitations without a referral

Question 7

patient access with provisions

Answer 7

ex: 45 calendar days or 12 visitrs
-prohibit certain diagnosis/tx without referrral
-require continunig education connected to access

Question 8

limited pt access

Answer 8

-access to eva only, fitness and wellness, and limited tx only to certain pt populations or under certain crimcustandces

Question 9

omission

Answer 9

no mention of any referral

Question 10

explicit

Answer 10

-language explicity states that there is no referral needed