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Intro To Practice > Unit 2: Regulatory > Flashcards

Unit 2: Regulatory Flashcards

1
Q

six areas of fraud

A

-false statements and or misrepresentations in order to obtain healthcare payments
-Paying for referrals with items or services
-making prohibited referrals for health services
-billing for services never provided
-Falsifying records in order to receive supplies
-Falsely billing for services at a higher level than what was provided

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2
Q

Why was the office of inspector general instructed to create guidelines regarding federal programs

A

The OIG guidelines were developed in order to ensure fair and legitimate charges

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3
Q

Why was the occupational safety and health administration created

A

OSHA (OHSA in Canada) was created to ensure safe and healthy working conditions

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4
Q

What does HIPAA stand for

A

Health insurance portability and accountability act.
-Establishes a framework for security and protection standards regarding healthcare data

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5
Q

Define informed consent

A

Patient is informed of
-A condition they may have
-The treatment and risks of treatment
-Possible risks if treatment is not performed

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6
Q

What are the stipulations of the red flags rule

A

Businesses should develop policies and procedures to thoroughly identify patients to prevent identity theft

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7
Q

What is ANSI

A

American national standards institute
-A nonprofit organization over seeing the development of standards for products, services, process systems, and personnel

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8
Q

What is a compliance program

A

A set of policies and procedures designed for any given practice detailing measures protecting every facet of patient and worker actions and information.

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9
Q

Four key regulatory bodies

A

-COA: College of Opticians of Alberta
-NACOR: National alliance of Canadian optician regulators
-IJCAHPO: International joint commission on Allied health personnel in ophthalmology
-ACO: Alberta college of optometrists

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10
Q

What does OHSA stand for

A

Occupational health and safety act

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11
Q

What does WHMIS stand for

A

Workplace hazardous materials information system

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12
Q

What does HIA stand for

A

Health information act

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13
Q

What does FOIP stand for

A

Freedom of information and protection of privacy

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14
Q

What does HPA stand for

A

Health professions act

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15
Q

What does PPCA stand for

A

Persons in protective care act

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16
Q

Criminal law

A

We are required to undergo a criminal record check before employment

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17
Q

Tort law

A

Deals with providing compensation to people who have suffered injury or harm because of another person’s actions. This can be intentional harm or negligence.

18
Q

Regulatory bodies: characteristics of a “college”

A

-Protects patient interests
-Mandatory registration
-Sets requirements for consideration
-Does not provide benefits
-Is accountable to Alberta health
-Regulates Opticians

19
Q

Regulatory bodies: characteristics of an “association”

A

-Protects Optician interests
-Voluntary registration
-Educational opportunities
-Advocates for members and provides benefits
-Accountable to membership
-Led by Opticians for Opticians

20
Q

Alberta’s three Main laws related to access and privacy

A

-FOIP (Applies to public bodies)
-HIA (Applies to individual health service providers and organizations
-PIPA (Applies to private sector organizations)

21
Q

What does PIPA stand for

A

Personal information protection act

22
Q

Custodians versus affiliates

A

Custodians
-Gatekeepers of patient files (Optometrists, ophthalmologists, Opticians)
Affiliates
-Employees of custodians

23
Q

Things that are part of a patient’s medical record

A

-Exam notes
-Referral letters
-Records of phone calls
-Eyeglass and contact lens orders
-Medications

24
Q

Examples of when to release health information without consent

A

-To another healthcare provider for continuity of care
-To minimize risk of harm to the health or safety of a minor, or an imminent danger to any person
-If required by another act, like the public health act
-To law enforcement if you believe you have information related to a crime

25
Q

How long should records of minors be kept

A

10 years from the date of last entry, or two years after they turn 18. whichever is longer

26
Q

Professional boundaries to abide by

A

-Physical
-Emotional
-Information
-personal Time
-Professional relationship

27
Q

What is PIPEDA

A

Personal information protection and electronic documents act
-federal level

28
Q

What does PIPA stand for

A

Personal information protection act
-Provincial

29
Q

What year was the health information act passed

A

2001

30
Q

What year was the health professions act passed

A

1999

31
Q

How many professions are regulated under the Health professions act

A

30

32
Q

What is the health professionals act for

A

Providing a framework for governance, registration, restricted activities, discipline and continuing competence.

33
Q

What is considered a restricted activity under the HPA

A

Any activity that requires a minimum level of competency and proper training

34
Q

What is the protection for persons in care act for

A

To manage the reporting, reviewing, and prevention of abuse involving clients

35
Q

COA

A

College of Opticians of Alberta

36
Q

NACOR

A

National alliance of Canadian optician regulators

37
Q

IJCAHPO

A

International Joint Commission On allied healthcare professionals and ophthalmology

38
Q

ACO

A

Alberta college of optometrists

39
Q

OIPC

A

Office of the information and privacy commissioner

40
Q

Four legislation acts

A

-Health information act
-Health professions act
-Persons in protective care act
-Freedom of information and protection of privacy act

Intro To Practice (2 decks)

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