Quiz #2: chapter 5

Question 1

Criminal law

Answer 1

The body of statutory and common law that deals with crime and the legal punishment of criminal offenses.

Question 2

Crime

Answer 2

Social harm defined and made punishable by law.

Question 3

Misdemeanor

Answer 3

Offense punishable by less than 1 year in jail and/or fine.

Question 4

Felony

Answer 4

Imprisonment in a state or federal prison for more than 1 year.

Question 5

Objectives of criminal law

Answer 5

• maintain public order and safety
• protect individuals
• use punishment as a deterrent
• provide for criminal rehabilitation

Question 6

Criminal procedure

Answer 6

• arrest
• complaints filed with court
• grand jury
• indictment

Question 7

Arraignment

Answer 7

Formal reading of the accusatory instrument. Describes a variety of documents accusing a defendant of an offense. Setting of bail.

Question 8

Pretrial conference

Answer 8

Meeting purposes of deliberation. Plea bargaining time. If no disposition reached, the case is set for trial.

Question 9

Criminal trial

Answer 9

Consistent process consisting of several steps. Standard proof beyond a reasonable doubt. Requires unanimous jury decision. Types in healthcare.

Question 10

Healthcare fraud

Answer 10

• false claims act
• anti-kickback statue
• ethics in patients referral act
• stark law
• HIPAA

Question 11

Office of inspector general

Answer 11

• protect the integrity of HHS programs
• impose monetary penalties
• exclude providers from participation in Medicare and Medicaid programs.

Question 12

Patient abuse

Answer 12

The mistreatment or neglect of individuals who are under the care of a healthcare organization. Takes many forms.

Question 13

Criminal negligence

Answer 13

Reckless disregard for the safety of others.

Question 14

Murder

Answer 14

Share common characteristics of setting, circumstance, and psychopathology. Detection is difficult.

Question 15

Theft

Answer 15

• cost millions annually
• patient valuables
• staff valuables
• supplies
• medical equipment

Question 16

Indictment

Answer 16

The official charging instrument accusing the defendant of criminal conduct.

Question 17

Types of criminal trials in healthcare

Answer 17

• identity theft
• fraud
• falsification of records
• misuse and theft of drugs
• patient abuse
• murder

Question 18

The false claims act of 1986

Answer 18

Prohibits knowingly presenting, or causing to be presented, to the government a false claim for payment; knowlingly making, using, or causing to be made or used a false record or statement to get a false claim paid or approved by the government; conspiring to defraud the government by getting a false claim allowed or paid; and knowingly making, using, or causing to be made or used a false record to avoid or decrease an obligation to pay or transmit property to the government.

Question 19

Anti-kickback statute of 1987

Answer 19

Provides for criminal penalties for certain acts impacting Medicare and state healthcare reimbursable services and prohibits certain solicitations or receipt of remuneration. It penalizes anyone who knowlingly and willfully solicits, receives, offers, or pays anything of value as an inducement in return for: referring an individual to a person for the furnishing or arranging for the furnishing of any item or service payable under the Medicare or Medicaid programs; and purchasing, leasing, or ordering or arranging for or recommending purchasing, leasing, or ordering any good, facility, service, or item payable under the Medicare or Medicaid programs.

Question 20

Ethics in patient referral act of 1989

Answer 20

Prohibits physicians who have ownership interest or compensation arrangements with a clinical laboratory from referring Medicare patients to that laboratory and requires all Medicare providers to report the names and provider numbers of all physicians or their immediate relatives with ownership interests in a provider entity.

Question 21

The health insurance portability and accountability act of 1996 (HIPAA)

Answer 21

Provides new criminal and civil enforcement tools and funding dedicated to the fight against healthcare fraud and a coordinated national framework for federal, state, and local law enforcement agencies; the private sector; and the public to fight healthcare fraud. It requires the U.S. attorney general and the U.S. secretary of the department of health and human services (DHHS), acting through the office of inspector general (OIG), to establish national healthcare fraud and abuse control program.

Question 22

Forms of patient abuse

Answer 22

• physical
• psychological
• medical
• financial