Rules and Regulations Flashcards
1
Q
What is the certifying body for PAs in the US?
A
NCCPA
National Commission on Certification of Physician Assistants
Awards -C to qualifying PAs
2
Q
What are requirements for initial national certification for PAs?
A
- Must graduate ARC-PA accredited PA program
- Must pass the PANCE
3
Q
What are requirements for national cerfication for PAs?
A
- Must log 100 hrs of CME every 2 years
- Must pay $150 maintenance fee every 2 years
- Must pass a recertification exam every 10 years
4
Q
What is required for the PANCE exam?
A
- Application and $550 registration fee
- Cannot apply to take PANCE until 90 days before expected completion date
- 5 hour exam, 300 multiple choice questions: five 60 minutes of 60 questions each, 45 minutes total break time
- Cannot actually take PANCE until at least 7 days after completing program program requirements
- 180 day timeframe to schedule exam
- Can only take once in a 90 day time period
- Max of 3 times per calendar year
5
Q
What is the window of eligibility for the PANCE?
A
- 6 year 6 attempt rule
- Eligibility ends when 6 attempts are done or 6 year window is done
- If student misses the six year 6 attempt window only way to become eligible again is to complete unabridged ARC-PA accredited PA program
6
Q
Where can you look for PANCE practice exams?
A
NCCPA
7
Q
How do you register for the PANRE exam?
A
- Requires application and $350 registration fee
- Cannot apply until 9th or 10th year of your recertification cycle
- 180 day timeframe to schedule exam
- Can only take once in a 90 day time period
8
Q
What is the PANRE exam?
A
- 4 hour exam
- 240 multiple choice questions
- 4 blocks of 60 questions each
- 45 minutes total break time
9
Q
What can you focus your PANRE exam on?
A
- Adult medicine, surgery, or primary care
- 60% of exam will still be focused on all areas of practice in primary care
- 40% of exam will be in questions in practice-focused area
10
Q
What is required to take the PANRE-LA alternative?
A
- Application and $350 registration fee
- Apply 6th year of recertification cycle
- Exam process in years 7-9
11
Q
What are components of the PANRE-LA alternative
A
- Quarterly blocks of 25 multiple choice questions
- 5 minutes per question with unlimited use of resources
- Rationale after each question
- Can pause and come back to the block as needed
- 8 quarters of blocks
- Can skip up to 4 quarters in 3 year period
- If 8 quarters completed, recertification is done
12
Q
What happens if you fail the PANRE-LA alternative?
A
3 attempts available to take and pass traditional PANRE in year 10
13
Q
What CME is required? What do you have to pay for maintenance?
A
- 100 hrs of CME every 2 years
- $150 maintenance fee every 2 years
- 5 2 year cycles between recertification exams
- 50 hrs category 1 CME
- 50 hrs category 2 CME
14
Q
What is considered category 1 CME?
A
- Formally planned activities- follow ACCME standards
- Documented acceptable needs assessment, learning objectives, educational design, evaluation method
- Prospectively certified for credit by an ACCME-accredited CME provider
15
Q
What is considered category 2 CME?
A
- Informally planned self-initiated activities
- Practice-based self study, consultations with colleagues, teaching, journal clubs, etc.
16
Q
A
16
Q
What is performance improvement CME (PI-CME)?
A
- Active learning with application to improve your practice
- Can be done in a team with other providers
- Three step process: (1) compare aspect of practice to national benchmarks or evidence-based standards, (2) based on comparison, develop and implement a plan for improvement in that area, (3) evaluate the impact of the improvement effort by comparing the results of the original comparison with new results
17
Q
What is self assessment CME (SA-CME)?
A
- Most traditional CME-passive
- SA=CME involves active process of evaluating one’s own performance, knowledge base or skill set
- Formal programs approved by AAPA as SA-CME
PANRE-LA also counts
18
Q
What is scope of practice?
A
- List of activities, responsibilities, procedures, and processes provider can perform
- Differs depending on state, type of practice, and provider who you are practicing under
- Supervising physician will complete a form stating what responsibilities and procedures you are allowed to perform
19
Q
What are four parameters that define scope of practice?
A
- PA’s education and experience
- State laws
- Facility policy
- Needs of practice and its patients
20
Q
What 3 requirements must an item meet to be in scope of practice?
A
- Must be educated academically or on-the-job and have documentation proving education
- Task must be allowed by local, state and federal laws for a member of your profession
- Facility and supervising physician must allow you to perform this task
21
Q
Why is HIPAA important?
A
- Ability to transfer and continue health insurance coverage for millions of American workers and their families when they change or lose their jobs
- Reduces health care fraud and abuse
- Mandates industry-wide standards for health care information on electronic billing and other processes
- Requires the protection and confidential handling of protected health information
22
Q
Who is covered by HIPAA?
A
- Health plans
- Health care providers
- Health care clearinghouses
- Business associates
23
Q
What information is protected by HIPAA?
A
- All individually identifiable health information
- Info that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual, and relates to:
Info about the individual’s past, present, or future mental or physical health or condition
Provision of healthcare to the individual
Past, present or future payment for the provision of health care to the individual
24
What information is not protected by HIPAA?
De-identified health information that neither identifies nor provides a reasonable basis to identify an individual
25
What are the general guidelines on releasing protected information?
* Release health information only as privacy rule permits or requires or when individuals authorize it in writing
26
Is there any occasion where we have to release information?
* We must release info only in two situations
* to individuals or their designated representatives when they request access to it
* To health and human services when they are undertaking a HIPAA compliance investigation
27
When can we release information without specific authorization to do so?
* To the individual
* For treatment, payment, and healthcare operations
* When the individual has the opportunity to agree or object --> informal permission
* Incidental uses or disclosures --> as long as there are reasonable safeguards in place
* Public interest and benefit: includes public health, law enforcement purposes, victims of abuse, etc,
* Limited data sets: example- research studies
28
How do we get permission to disclose information?
* Written authorization: in specific terms, clearly stated, and contain information about the data to be used or disclosed
* Most psychotherapy notes must have written authorization to be released
29
How much information can we disclose?
* Minimum necessary: minimum amount of information needed to accomplish the intended purpose of the disclosure
* Minimum requirement is not enforced in cases such as: disclosure for treatment purposes, disclosure to the individual, disclosure approved by an authorization, disclosure for legal purposes or compliance review
30
What type of disclosure notice do we have to provide under HIPAA?
* Notice of privacy practices
* Often have acknowledgement of notice receipt
31
What must be components of notice of privacy practices?
* Must describe ways in which we use patient information
* Must be provided to patients as soon as care starts
32
What rights do patients have about their health record?
* Can review and obtain a copy of record
* Can make amendment request if feel incorrect data in file
* Can have a statement of disagreement in file if amendment request denied
* Can receive accounting of disclosures of their helath information up to 6 years prior to request
* Can request that disclosure of their information is restricted
* Can request an alternative means or location for receiving communications about protected health information
33
What services do individuals covered by HIPAA have to provide?
* Privacy policies/procedures and a privacy officer
* Training and enforcement of privacy rules
* Mitigate any harmful effect it learns was caused by unauthorized or inappropriate information disclosure
* Data safeguards in place
* Procedures allowing for complaints
* Must not retaliate against people for exercising rights provided by HIPAA, for assisting in investigation regarding HIPAA
* Can't require individuals to waive their right to HIPAA to receive treatment, payment, benefits
* Must retain records pertinent to HIPAA
34
35
How does HIPAA pertain to representatives or minors?
* Authorized personal representatives must be treated the same as the individual
* Parents are considered personal representatives for minors in most circumstances
* Exception: if belief that the personal representative is abusing or neglecting individual
36
What are penalties of not following HIPAA?
* Civil money penalty of $100-$50,000 per violation with cap of $1.5 million per calendar year
* Criminal violation if willful violation or wrongful conduct
37
When would the civil money penalty be waived?
* Failure to comply not due to willful neglect
* Corrected within 30 day period after responsible party learned or should have known failure to comply had occurred
38
What are civil violation punishments for HIPAA?
* Knowingly obtains or discloses: up to $50,000 and up to 1 year imprisonment
* Obtains or discloses with false pretenses: up to $100,000 and up to 5 years imprisonment
* Intent to sell, transfer, or use information for commercial advantage, personal gain, or malicious harm: up to $250,000 and up to 10 years imprisonment
