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Fundamentals of Law

for Health Informatics


and Information
Management
Second Edition
Check Your Understanding
Chapter Answers
CHA!E" #
Check Your Understanding #$#
1. A hybrid record is refers to record that is totally electronic. False
2. An electronic health record can be managed across more than one healthcare organization. True
3. Confidentiality refers to the right to be left alone. False
4. HITCH !idens the sco"e of "ri#acy and security "rotections under HI$AA. True
%. $ri#ileged communication is a legal conce"t designed to "rotect the communication bet!een t!o "arties. True
Check Your Understanding #$%
1. &!nershi" of a health record generated by a doctor on a "atient belongs to the "atient. False
2. A custodian of records is res"onsible for certifying that a record is !hat it "ur"orts to be. True
3. 'hen a "atient refuses treatment he or she is e(ercising the ethical "rinci"le of beneficence. False
4. In a mal"ractice case) a "rofessional code of ethics may be used as a benchmar* for !hat should be acce"table
"ractice by a healthcare "rofessional. True
%. The ethical "rinci"le of nonmaleficence refers to ma*ing sure rules are fairly and consistently a""lied to all. False
CHA!E" %
Check Your Understanding %$#
1. $ri#ate la! defines rights and duties bet!een indi#iduals and the go#ernment. False
2. +tatutes are enacted by legislati#e bodies. True
3. Administrati#e la! is created by court decisions. False
4. $ersuasi#e authority occurs !hen a court loo*s to another court,s decision for guidance) e#en if it is not
re-uired to do so. True
%. .nder the theory of stare decisis) a higher court must loo* to the decision of a lo!er court. False
Check Your Understanding %$%
1. /urisdiction is a territory of legal control. True
2. The ..+. Congress is a bicameral model. True
3. Federally) ultimate e(ecuti#e branch "o!er rests !ith the $resident. True
4. .nder the theory of se"aration of "o!ers) each branch of go#ernment is gi#en e("anded "o!ers. False
%. /udicial dis"utes may arise from constitutional challenges to e(isting la!s. True
2
Check Your Understanding %$&
1. A""ellate courts hear a""eals on final 0udgments of trial court decisions. True
2. An o"inion is the !ritten argument of one of the "arties in a la!suit. False
3. Courts of limited 0urisdiction hear cases "ertaining to a "articular sub0ect matter. True
4. 1i#ersity 0urisdiction enables "arties from different states to engage in a la!suit in federal court. True
%. In mediation) a third "arty ma*es a final decision about a dis"ute bet!een "arties. False
CHA!E" &
Check Your Understanding &$#
1. $rocedural la! encom"asses a court,s rules that guide a la!suit. True
2. Class action la!suits "roceed for grou"s of consumers. True
3. A cross2claim is a claim by a defendant against a "laintiff. False
4. /oinder in#ol#es bringing an outsider into a la!suit as a codefendant. True
%. 3otification of a la!suit occurs through ser#ice. True
Check Your Understanding &$%
1. 1isco#ery allo!s "arties in a la!suit to use strategies to obtain information held by other "arties. True
2. Admissibility refers to e#idence that "arties can obtain during the "retrial "eriod. False
3. A de"osition does not occur under oath. False
4. Authentication is #erification of a record,s #alidity. True
%. An inde"endent mental e(amination may not be re-uested as a ty"e of disco#ery. False
Check Your Understanding &$&
1. A sub"oena is another name for a court order. False
2. In most cases) a sub"oena for health records must be accom"anied by "atient authorization. True
3. 'ritten ob0ections to sub"oenas may be made in a motion to -uash. True
4. A subpoena duces tecum "rimarily see*s an indi#idual,s testimony. False
%. 4aterial should al!ays remain in a health record that has been sub"oenaed) e#en if that material !as not
re-uested in the sub"oena. False
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Check Your Understanding &$'
1. Cases are rarely settled before they reach trial. False
2. /udicial search !arrants are more li*ely to be used to obtain health records in criminal cases than in ci#il cases.
True
3. A "ro se "laintiff is one !ho re"resents himself during litigation. True
4. An e("ert !itness is called to testify based on her o!n obser#ations of the situation that "rom"ted the la!suit. False
%. A bench trial is a trial !ithout a 0ury. True
Check Your Understanding &$(
1. In ci#il cases) the burden of "roof is 5beyond a reasonable doubt.6 False
2. 3oneconomic com"ensatory damages ha#e been targeted as a cause of rising "rofessional mal"ractice
insurance "remiums. True
3. The legal system does not allo! "hotoco"ies of health records to be admitted into e#idence. False
4. The "arty that a""eals a lo!er court,s decision is the a""ellee. False
%. 7arnishment is a court2ordered collection of money damages that is a!arded to the "laintiff through a set2aside
of the defendant,s !ages. True
CHA!E" '
Check Your Understanding '$#
1. Health information is im"ortant as e#idence in many ty"es of ci#il and criminal cases. True
2. In state court) a state,s rules of e#idence !ill determine !hether a "iece of information is disco#erable. True
3. lectronically stored information is no! obtained more fre-uently through disco#ery than it !as in the "ast.
lectronic disco#ery includes com"uter forensics. True
4. 2mail can generally not be sought as "art of the electronic disco#ery "rocess. False
Check Your Understanding '$%
1. The Federal 8ules of Ci#il $rocedure !ere amended in 299: to address the disco#ery of electronic data. True
2. .nder the Federal 8ules of Ci#il $rocedure) court2im"osed sanctions are not "ermitted if a "arty fails to
"ro#ide electronically stored information lost as the result of a good2faith o"eration. True
3. In general) documents must be "roduced in res"onse to a sub"oena as they are *e"t in the usual course of
business. True
4. A hybrid record is a fully electronic record. False
%. A legal hold re-uires the "reser#ation of both "a"er and electronic records. True
4
Check Your Understanding '$&
1. +"oliation is the accidental destruction of e#idence. False
2. &rganizations !ith electronic information should de#elo" guidelines to identify !here information may be
hidden or not readily a""arent. True
3. 8ele#ant e#idence !ill al!ays be admitted into e#idence. False
4. Circumstantial e#idence re-uires reasoning to "ro#e a fact. True
%. Testimonial and documentary e#idence may be combined during a trial. True
Check Your Understanding '$'
1. The best e#idence rule "rohibits the use of a du"licate record in lieu of the original. False
2. 4uch documentation in the health record is hearsay. True
3. The business records e(ce"tion often enables health records to be admitted as e#idence. True
4. The "hysician2"atient "ri#ilege is used to encourage full disclosure of rele#ant information by "atients to their
"hysicians. True
%. It is the "hysician !ho holds the "hysician2"atient "ri#ilege. False
Check Your Understanding '$(
1. Incident re"orts are created for "atient treatment "ur"oses and should be a "art of the health record. False
2. +tate la! may "rotect incident re"orts from being admitted into e#idence. True
3. $eer re#ie! in#ol#es acti#ities underta*en to ensure the "ro#ision of -uality care. True
4. $laintiffs commonly attem"t to disco#er and admit "eer re#ie! records into e#idence during negligence cases
against health care "ro#iders. True
%. The "hysician2"atient "ri#ilege may be !ai#ed !hen a "arty claims damages by the "hysician and "uts his
"hysical or mental condition at issue. True
CHA!E" (
Check Your Understanding ($#
1. A tort is a ci#il !rong. True
2. ;attery is an intentional tort that in#ol#es nonconsensual contact !ith the "laintiff. True
3. Assault is an intentional tort that in#ol#es nonconsensual contact !ith the "laintiff. False
4. The la! "ro#ides e(ce"tions to false im"risonment liability !here in#oluntarily hos"italized "atients "ose
harm to themsel#es or others. True
%. Intentional infliction of emotional distress is a tort that results in e(treme emotional distress to the "laintiff. True
5
Check Your Understanding ($%
1. 3egligence is the second most common basis for medical mal"ractice la!suits) follo!ing intentional torts. False
2. The standard of care is !hat an indi#idual is e("ected to do or not do in a "articular situation. True
3. 4isfeasance is the failure to act "er one,s duty and according to ordinary "rudence. False
4. The t!o ty"es of causation are actual and "ro(imate. True
%. $uniti#e damages "unish the !rongdoer for tortious conduct that !as committed. True
Check Your Understanding ($&
1. $er the doctrine of res ipsa loquitur) an inference or "resum"tion of the defendant,s negligence is "ermitted. True
2. Contributory negligence com"letely bars reco#ery by a "laintiff !hose conduct contributed to the "laintiff,s
in0ury. True
3. Assum"tion of the ris* is a #iable defense by "hysicians in most medical mal"ractice cases. False
4. $er the theory of cor"orate negligence) a hos"ital is liable for the torts of its em"loyees. False
%. $er the theory of respondeat superior) a hos"ital is liable in its o!n right to the "atients it ser#es. False
Check Your Understanding ($'
1. The doctrine of strict liability is most common in "roducts liability cases. True
2. <ibel is !ritten defamation. True
3. Fiduciary duty is the obligation to act in the best interest of another "arty. True
4. To successfully claim breach of confidentiality) a "laintiff must establish that the defendant had a duty not to
disclose the information. True
%. 7ood +amaritan statutes encourage good2faith emergency assistance by "ro#iding immunity if ordinary
negligence is committed by those !ho assist in medical emergencies. True
Check Your Understanding ($(
1. A statute of limitations "laces time limits on certain claims. True
2. A tolled statute of limitations is one that has been delayed or sus"ended. True
3. 'rongful acts committed in the healthcare en#ironment can lead only to ci#il liability. False
4. 1iminishing returns on insurers, in#estments is belie#ed to be a contributing factor to the medical mal"ractice
insurance crisis. True
%. Collateral source "ayments are "ayments recei#ed by "laintiffs from sources other than the defendant. True
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CHA!E" )
Check Your Understanding )$#
1. The o!ners of a cor"oration are generally shielded from "ersonal liability for the debts of the cor"oration)
although the cor"oration itself can sue and be sued. True
2. 5$iercing the cor"orate #eil6 enables the o!ners of a cor"oration to be shielded from liability for !rongdoing
committed through the cor"oration. False
3. Fiduciary duty includes the duty of loyalty and the duty of res"onsibility. True
4. A not2for2"rofit cor"oration is "rohibited from ma*ing money. False
%. A healthcare organization may not form as a "artnershi". False
Check Your Understanding )$%
1. A 5hold harmless6 clause may "ro#ide for com"ensation by one indi#idual to another. True
2. A breach of contract 0udgment al!ays re-uires monetary com"ensation. False
3. An acce"tance of an offer reflects a meeting of the minds regarding the contract terms. True
4. To be #alid) a contract must be in !riting. False
%. 4ista*e of fact is a "otential defense for non"erformance of a contract. True
Check Your Understanding )$&
1. Antitrust #iolations are generally go#erned by indi#idual state la!s. False
2. All restraints of trade are "er se antitrust #iolations. False
3. 4edical staff credentialing can lead to antitrust concerns. True
4. There are nine safety zones in health care that the federal go#ernment !ill generally not challenge as antitrust
#iolations. True
%. The +herman Act is the oldest of the three ma0or federal antitrust statutes. False
Check Your Understanding )$'
1. conomic credentialing is the granting of medical staff "ri#ileges based on -uality of care indicators. False
2. Antitrust claims are only #alid if they relate to an entire grou" of indi#iduals !ho ha#e been denied "ri#ileges
at a healthcare organization. False
3. A grou" boycott is a "er se antitrust #iolation. True
4. Courts u"hold all non2com"ete agreements in order to "rotect the li#elihood of organizations that an em"loyee
or contractor lea#es for other o""ortunities. False
%. The number of "rocedures "erformed by a "ro#ider may be lin*ed to clinical "erformance and -uality issues
!hen determining medical staff "ri#ileges. True
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CHA!E" *
Check Your Understanding *$#
1. A "erson must gi#e "ermission to recei#e medical treatment through e("ress consent. True
2. Informed consent should include alternati#es to the "ro"osed treatment or "rocedure. True
3. The la! "ermits a "resum"tion of consent during emergency situations. True
4. The 7enetic Information 3ondiscrimination Act =7I3A> a""lies to any entity that has the "otential to ma*e a
decision about a "erson based on that "erson,s genetic information. False
%. Com"ound authorizations combine informed consent !ith authorization for the use and disclosure of a
research sub0ect,s health information. True
Check Your Understanding *$%
1. .nless it is designated as durable) a "o!er of attorney is only effecti#e !hen the "rinci"al has ca"acity. True
2. A durable "o!er of attorney for healthcare decisions e("resses an indi#idual,s !ishes to limit treatment
measures !hen s"ecific health2related diagnoses or conditions e(ist and the indi#idual cannot communicate on
his o!n behalf. False
3. The $atient +elf21etermination Act re-uires hos"itals that are 4edicare "ro#iders to document in the health
record !hether an indi#idual has an ad#ance directi#e. True
4. The .niform Anatomical 7ift Act "ermits an anatomical gift by any "erson designated to ma*e decisions about
a decedent,s remains. True
%. The technical "rocess for e(ecuting a li#ing !ill is standardized nationally. False
Check Your Understanding *$&
1. A com"etent adult,s right to refuse consent to medical treatment a""lies e#en !hen the treatment is lifesa#ing.
True
2. In right2to2die cases) courts !ill balance an indi#idual,s right to self2determination against the interest of the
state. True
3. The .niform Health2Care 1ecisions Act suggests that in the absence of a surrogate) a s"ouse be the first "erson
to ma*e healthcare decisions on behalf of an indi#idual !ho has lost mental ca"acity. True
4. An emanci"ated minor is one !ho has not been afforded legal status as an adult. False
%. +tate la!s generally allo! minors to see* medical treatment for se(ually transmitted diseases !ithout "arental
consent. True
Check Your Understanding *$'
1. ;attery is the usual basis of a claim for !hich an indi#idual did not gi#e consent for a "rocedure that !as
"erformed. True
2. The basis for a lac* of informed consent claim is generally negligence. True
3. A treating "ro#ider should delegate the informed consent "rocess to another "erson. False
4. 7eneral consent allo!s healthcare "ro#iders to "ro#ide routine nonin#asi#e ser#ices. True
%. ;oth !ritten and oral consent should be documented in an indi#idual,s health record. True
CHA!E" +
Check Your Understanding +$#
1. Health records using a combination of "a"er and electronic formats are hybrid records. True
2. The most im"ortant "ur"ose of the health records is to "ro#ide "roof of ser#ices for reimbursement. False
3. The health record is not "ermitted to ser#e as an organization,s business record. False
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4. There are both federal and state #ersions of the .niform $hotogra"hic Co"ies of ;usiness and $ublic 8ecords
as #idence Act. True
%. The custodian of the legal health record is res"onsible for collecting) "rotecting) and archi#ing the record. True
Check Your Understanding +$%
1. 5$atient a""ears to be an(ious6 is an e(am"le of good documentation in the health record. False
2. Charting for a bloc* of time is recommended because it sa#es time. False
3. 4edical staff byla!s must state the categories of "ersonnel !ho are authorized to acce"t "hysician orders. True
4. $rofessional conclusions of indi#idual "ractitioners should be documented in the health record so that they
agree !ith one another. False
%. A 0ury may be "ermitted to infer "ro#ider negligence based on missing or incom"lete information in the health
record. True
Check Your Understanding +$&
1. Authentication refers to the ability to #erify the source of an entry in the health record. True
2. Author initials are "rohibited as an authentication mechanism in the health record. False
3. 4etadata "ro#ides information about an entry,s content) including date and time of creation. True
4. A countersignature signifies re#ie! and e#aluation of the actions and documentation of another "ro#ider. True
%. Auto2authentication is fa#ored by the /oint Commission because it is an efficient authentication tool. False
Check Your Understanding +$'
1. A /oint Commission2accredited organization may use any abbre#iation in health record documentation as long
as it is e("lained in a facility2!ide *ey or legend. False
2. Illegibility has been reduced through the "resence of H8s. True
3. Incorrect information in the health record should be obliterated so that it cannot be confused !ith the u"dated)
corrected information that is "laced in the record. False
4. A late entry in the health record should not be identified as such because it may lead to negligence liability. False
%. ?ersion management is ho! an organization handles numerous #ersions that may e(ist of a document. True
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Check Your Understanding +$(
1. A com"uter system,s "rint function "ro#ides additional challenges for organizations !ith H8s. True
2. A "atient,s "ersonal health record is a business record. False
3. A master "atient inde( is a directory of "atient2identifying information. True
4. +tatutes of limitations may not be considered !hen establishing a health record retention schedule. False
%. 'hen establishing a health record retention schedule) an organization must retain all records for the same
"eriod of time. False
Check Your Understanding +$)
1. Health record dis"osition includes transferring records from "a"er to an o"tical imaging system. True
2. 'hen a "hysician closes a "ractice) all health records should be destroyed immediately to "rotect the "ri#acy
of "atient information. False
3. 1ata in a health record needs to be *e"t fore#er. False
4. 1egaussing a hard dri#e in#ol#es neutralizing it !ith a magnetic field as a method to erase "atient information.
True
%. 'hen an e2mail message is deleted) it is eliminated from an organization,s electronic system. False
CHA!E" ,
Check Your Understanding ,$#
1. The $ri#acy 8ule resides in the administrati#e sim"lification "ro#ision of Title II of HI$AA. True
2. The HITCH Act of the A88A of 299@ made significant changes to the HI$AA $ri#acy 8ule. True
3. The F&IA !as enacted to address the "ri#acy of health information. False
4. 1rug and alcohol abuse treatment records ha#e recei#ed "rotection under federal la!. True
%. The Conditions of $artici"ation regulate only "ro#iders !ho recei#e funds from the 4edicare and 4edicaid
"rograms. True
Check Your Understanding ,$%
1. A C needs only consider its em"loyees !hen e#aluating HI$AA com"liance !ithin the organization. False
2. The HITCH Act has strengthened ;A re-uirements regarding com"liance !ith the $ri#acy 8ule. True
3. In "art) information must be indi#idually identifiable to meet the definition of $HI. True
4. 1eidentified information recei#es $ri#acy 8ule "rotection. False
%. A ;A is anyone !ho might ha#e access to a C,s $HI. False
10
Check Your Understanding ,$&
1. .nder the $ri#acy 8ule) a "ersonal re"resentati#e must be treated the same as the indi#idual regarding the use
and disclosure of the indi#idual,s $HI. True
2. ;y definition) a 18+ includes billing records. True
3. A hos"ital em"loyee,s "re2em"loyment "hysical e(amination is in his "ersonnel file in Human 8esourcesA this
re"ort is $HI. False
4. A uni#ersity !ith a medical center is a hybrid entity under the $ri#acy 8ule. True
%. +ome of the $ri#acy 8ule,s re-uirements are rela(ed or remo#ed !here $HI is needed for "ur"oses of T$&.
True
Check Your Understanding ,$'
1. The HI$AA consent e("lains an indi#idual,s rights and the C,s legal duties !ith res"ect to $HI. False
2. $er the HI$AA $ri#acy 8ule) "atient authorization is re-uired for the use or disclosure of $HI unless it meets
an e(ce"tion !hereby authorization is not re-uired. True
3. Although an indi#idual must #erbally agree to be included in a facility directory) !ritten authorization is not
re-uired. True
4. &ne of the 12 "ublic interest and benefit e(ce"tions to the authorization re-uirements is disclosure to organ
"rocurement agencies. True
%. Incidental disclosures do not re-uire an indi#idual,s !ritten authorization. True
Check Your Understanding ,$(
1. .nder no circumstance should health records from other facilities be made a "art of an organization,s
18+. False
2. The minimum necessary "rinci"le a""lies to disclosures made for T$& "ur"oses. False
3. An indi#idual has the right of access to her "sychothera"y notes. False
4. $er HITCH) an accounting of disclosures !ill be re-uired in the future for T$& disclosures made by co#ered
entities !ith H8s. True
%. Com"laints about alleged $ri#acy 8ule #iolations must be submitted to the co#ered entity. False
Check Your Understanding ,$)
1. The threshold for re-uired media notification in the e#ent of a "ri#acy breach is 399 affected indi#iduals. False
2. All acti#ities that meet the HI$AA definition of mar*eting must recei#e "rior !ritten authorization from the
indi#idual. False
3. The breach notification re-uirement is ne! under HITCH. True
4. Fundraising acti#ities that target indi#iduals based on diagnosis re-uire "rior authorization. True
%. A conditioned authorization may be allo!ed by A88A in certain situations. True
11
Check Your Understanding ,$*
1. The $ri#acy 8ule "ro#ides a floor) or minimum) of "ri#acy re-uirements. True
2. ;reach notification is one ty"e of mitigation under the $ri#acy 8ule. True
3. In order to sim"lify "rocesses) indi#iduals may be re-uired to !ai#e their rights under the $ri#acy 8ule to
obtain treatment or benefits eligibility. False
4. .nder HITCH) state attorneys general may bring ci#il actions in federal district court on behalf of residents
belie#ed to ha#e been negati#ely affected by a HI$AA #iolation. True
%. nforcement of the $ri#acy 8ule !ill continue to o"erate e(clusi#ely on a com"laint2based system. False
CHA!E" #-
Check Your Understanding #-$#
1. The +ecurity 8ule re-uires Cs to ensure the integrity and legality of "atient information. False
2. The goal of the +ecurity 8ule is to ensure that "atient information is "rotected from unauthorized access)
alteration) deletion) and transmission. True
3. C4+ is the enforcement agency for the +ecurity 8ule. False
4. Cs can decide to com"ly !ith only the $ri#acy 8ule and don,t ha#e to com"ly !ith the +ecurity 8ule. False
%. &nly healthcare "ro#iders are re-uired to com"ly !ith the +ecurity 8ule. False
Check Your Understanding #-$%
1. The +ecurity 8ule contains "ro#ision that Cs can ignore. False
2. The +ecurity 8ule is com"letely technical and re-uires com"uter "rogrammers to address. False
3. The +ecurity 8ule contains both re-uired and addressable standards. True
4. The +ecurity 8ule contains encry"tion s"ecifications that all Cs must com"ly. False
%. The Conditions of $artici"ation restrict "ayment to "ro#iders !ho are not com"liant !ith the +ecurity 8ule.
False
CHA!E" ##
Check Your Understanding ##$#
1. Internal security breaches are far more common than e(ternal breaches. True
2. The 4edical identity theft and Assum"tion 1eterrence Act of 1@@B ma*e it a federal crime to commit an act of
medical identity theft. True
3. 4edical identity theft includes the use of a "atient,s financial information to "urchase goods or ser#ices e#en if
they are not medical in nature. False
4. Healthcare organizations are e(cluded from the definition of 5creditor6 under FACTA. False
%. 8ed flags are used to hel" a healthcare "ro#ider detect medical identity theft. True
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Check Your Understanding ##$%
1. C;AC is less stringent than 8;AC. False
2. ;iometric identifiers signify something that the user *no!s. False
3. An audit trail is a record that sho!s !hen a "articular user accessed a com"uter system. True
4. m"loyee nondisclosure agreements are "articularly im"ortant for em"loyees !ho !or* in remote locations or
telecommute. True
%. m"loyee training "rograms are not necessary to "rotect the security of $HI. False
Check Your Understanding ##$&
1. 1ata encry"tion ensures that data transferred from one location on a net!or* to another is secure from
ea#esdro""ing or data interce"tion. True
2. An organization,s fire!all limits e(ternal Internet users from accessing "ortions of the healthcare net!or*)
but it does not limit internal users from accessing "ortions of the Internet. True
3. Facsimile machines "ro#ide a highly secure method of communication. False
4. 2mail related to "atient care should be *e"t se"arate from the "atient medical record. False
%. 1isaster reco#ery and contingency "lans related to e$HI are nice to ha#e but not necessary. False
CHA!E" #%
Check Your Understanding #%$#
1. &!nershi" of a health record has traditionally been granted to the "atient. False
2. A com"etent adult may !ish to a""oint another "erson to be his or her "ersonal re"resentati#e. True
3. A minor !ho is emanci"ated must still ha#e his or her "arents authorize for disclosure of health information.
False
4. A noncustodial "arent has the right to access the healthcare information of their minor children sub0ect to other
mitigating circumstances related to the minor,s rights to access. True
%. Attorneys ha#e automatic access to "atient information because they are an officer of the court. False
Check Your Understanding #%$%
1. HI$AA does not distinguish highly sensiti#e health information from other ty"es of health information. False
2. $ri#ilege statutes legally "rotect confidential communications bet!een "ro#ider and "atient related to
diagnosis and treatment from disclosure during ci#il and some criminal misdemeanor litigation. True
3. The duty to !arn obligation enables a "hysician to disclose information to a third "arty !ho may be the #ictim
of harm "er"etrated by a "atient. True
4. For a substance alcohol and drug abuse "rogram to be in com"liance !ith the $ri#acy 8ule the authorization of
disclosure of information should include s"ecific elements re-uired by the $ri#acy 8ule. True
%. Health records of HI?CAI1+ "atients should be clearly mar*ed as such. False
Check Your Understanding #%$&
1. Title I of 7I3A allo!s for health "lans to use genetic for insurance "remium2setting decisions. False
13
2. Title II of 7I3A focus on em"loyment and "ut restrictions on em"loyers for using genetic information to ma*e
em"loyment decisions. True
3. 4ost states deem ado"tion records as confidential and only allo! release of such records !ith a court order.
True
4. An ado"tee,s birth record is restricted in order to "rotect the biological "arent=s> unless both "arties ha#e
agreed to ha#e their identities disclosed in a mutual consent registry. True
%. Courts !ill decide if an ado"tee may access the health information of his or her biological "arents for health
ris* "ur"oses. True
Check Your Understanding #%$'
1. In absence of a legal e(ecutor or administrator of an estate a sur#i#ing s"ouse or other descendent my access
the health records of the deceased "atient. True
2. The Freedom of Information Act along !ith o"en records la!s including "ublic records or sunshine la!s
re-uires that federal or state entities ma*e information generated in the normal course of business including
health information "ublic and sub0ect to access by !hoe#er re-uests the information. False
3. An em"loyer is entitled to information about an em"loyee,s medical !or* fitness but not to a diagnosis or
other s"ecific health details. True
4. The $atriot Act of 2991 and the Homeland +ecurity Act of 2992 allo! unauthorized access to $HI u"on re-uest
in order to "rotect the country. True
%. The lectronic 8ecord ("ress initiati#e s"onsored by the +ocial +ecurity Administration to "rocess disability
claims does not re-uire "atient authorization for release of $HI. False
Check Your Understanding #%$(
1. 1ocuments not considered "art of the legal health record for e(am"le li*e corres"ondence) incident re"orts)
and information about other family members should be released as "art of the <H8. False
2. $roof of a re-uester,s relationshi" to a "atient must be #erified before health information is released to the
re-uester. True
3. A re-uest for any and all information on a "atient should be honored !ithout -uestion as long as the
authorization form is signed by the "atient. False
4. Health organizations and "ro#iders may charge a reasonable fee as set by state la! for co"ying health records
in res"onse to a re-uest for "atient information. True
%. HI$AA re-uires that for the "ur"ose of accounting of disclosures only $HI that has been released electronically
or in !riting must be accounted for. False
14
CHA!E" #&
Check Your Understanding #&$#
1. +tate re-uired re"orting la!s are an e(ce"tion to the doctrine of "reem"tion. True
2. 'hen information is released to meet state re-uired re"orting la!s) the release does not ha#e to be included in
the facility,s accounting of disclosures. False
3. Central registries are co#ered by and must adhere to the re-uirements of HI$AA. False
4. Abuse of the elderly is limited to financial e("loitation of an elder "erson,s assets. False
%. $hysical abuse is usually the only ty"e of maltreatment that must be re"orted under child abuse re"orting la!s.
False
Check Your Understanding #&$%
1. The attending "hysician usually has res"onsibility for filing the death certificate. False
2. 8e"orting of notifiable diseases !ithout the "atient,s authorization is allo!ed under the "ublic interest and
benefit e(ce"tion under HI$AA. True
3. 3ational hos"ital -uality measures data may only be released to the DI& or the C1AC !ith a signed
authorization from the "atient. False
4. #ery hos"ital recei#ing reimbursement from 4edicare for im"lantable cardiac defibrillators must submit data
to the American College of Cardiologists 3ational Cardio#ascular 1ata 8egistry. True
%. Federal la! re-uires that a hos"ital notify the designated organ "rocurement organization =&$&> in a timely
manner regarding s"ecified organ donors !ho die in the hos"ital or for !hom death is imminent. True
Check Your Understanding #&$&
1. Information included in state registries is considered "ublic information. False
2. Immunization registries are different from other state registries because they allo! access by the indi#iduals
included in the registry or their re"resentati#es) such as "arents. True
3. Trans"lant registries may include data about organ donors as !ell as organ reci"ients. True
4. Im"lant registries are fre-uently de#elo"ed in res"onse to highly "ublicized cases of harm resulting from
im"lants to "ro#ide for easier notification of indi#iduals affected. True
%. +tate!ide cancer registries are fre-uently re-uired to re"ort data to the 3ational Center for Health +tatistics.
False
15
CHA!E" #'
Check Your Understanding #'$#
1. 8is* management focuses on an organization,s financial liability. True
2. Duality and ris* management "rograms ha#e e#ol#ed concurrently. True
3. A hos"ital,s strongest legal defense is the doctrine of charitable immunity. False
4. Darling vs. Charleston Community Memorial Hospital is a landmar* case that e(tended negligence liability to
hos"itals. True
%. A 1@@@ re"ort by the Institute of 4edicine concluded that #ery fe! "re#entable errors lead to "atient deaths in
hos"itals. False
Check Your Understanding #'$%
1. A re#ie! of "atient com"laints can assist in the ris* identification "rocess. True
2. stablishing the fre-uency or se#erity of a "articular loss occurring is "art of the ris* treatment "rocess. True
3. A claims management "rogram should include the retention of all insurance "olicies. True
4. An incident re"ort should be com"leted by an indi#idual !ho in#estigated a situation and determined its cause.
False
%. Incident re"orts are "rotected from disco#ery in all states. False
Check Your Understanding #'$&
1. $atient non2com"liance !ith medical ad#ice should not be documented in the health record because it might
u"set the "atient. False
2. A sentinel e#ent is an une("ected occurrence in#ol#ing death or serious "hysical or "sychological in0ury) or the
ris* thereof. True
3. All medical errors are sentinel e#ents. False
4. /oint Commission accredited organizations are e("ected to com"lete a root cause analysis follo!ing a sentinel
e#ent. True
%. 3ational $atient +afety 7oals are o"tional standards that an organization may choose to meet in order to
recei#e a s"ecial designation from the /oint Commission. False
Check Your Understanding #'$'
1. $atient2centered care is one of 19 ob0ecti#es recommended by the Institute of 4edicine in 2991 as central to
the ..+. healthcare system. False
2. The American Hos"ital Association,s $atient ;ill of 8ights is no! the $atient Care $artnershi") !hich focuses
on "atient e("ectations) rights) and res"onsibilities. True
3. The Hill2;urton Act is federal legislation) "assed in 1@4:) that "ro#ided hos"itals money for construction and
modernization. True
4. 4TA<A !as "assed by Congress to combat transfer and discharge of "atients) and refusal to treat) based on
inability to "ay. True
%. In addition to recognizing "atient rights) many hos"itals ha#e ado"ted codes of "atient res"onsibility. True
Check Your Understanding #'$(
1. The 3ational $ractitioner 1ata ;an* collects mal"ractice and disci"linary action information on "hysicians.
True
2. The 4edicare Conditions of $artici"ation encourage restraints in the interest of "atient safety. False
3. Duality Im"ro#ement &rganizations "ro#ide consultation and -uality im"ro#ement resources to a !ide range
of "ro#iders. True
4. The <ea"frog 7rou" consists of organizations that are res"onsible for "urchasing healthcare co#erage for
em"loyees. True
16
%. $ay for "erformance "ro#ides incenti#es to healthcare "ro#iders to deli#er high2-uality care. True
CHA!E" #(
Check Your Understanding #($#
1. Healthcare abuse relates to a false re"resentation of fact. False
2. ;illing for ser#ices ne#er rendered is one of the most common ty"es of healthcare fraud. True
3. .nbundling is a billing "ractice "referred by "ayers. False
4. A Cor"orate Integrity Agreement is a #oluntary com"liance "rogram ado"ted by a healthcare organization.
False
%. Although desirable) correct documentation in the health record is not necessary to su""ort billing. False
Check Your Understanding #($%
1. The False Claims Act targets anyone !ho *no!ingly submits false claims to a "ri#ate insurance com"any.
False
2. A qui tam action in#ol#es !histleblo!ers !ho file a com"laint alleging fraud against the go#ernment. True
3. The False Claims Act utilizes a *no!ing standard) !hich includes acting in deliberate ignorance. True
4. The Federal Anti2Eic*bac* +tatute targets those !ho "ay) solicit or recei#e "ayment in e(change for business
that !ill be reimbursed by a federal healthcare "rogram. True
%. .nder the C4$ la!) a hos"ital may be e(cluded from the 4edicare "rogram if its !rongdoing caused harm to
an HH+ "rogram. True
Check Your Understanding #($&
1. The +tar* <a! "rohibits "hysicians from ordering certain health ser#ices for 4edicare "atients from entities in
!hich the "hysician or immediate family member has a financial relationshi". True
2. A "ur"ose of antitrust la!s is to discourage mar*et"lace com"etition. False
3. In its definition of 5referral)6 the +tar* <a! e(cludes a re-uest by a radiologist for diagnostic radiology
ser#ices. True
4. +tate healthcare fraud F abuse la!s a""ly to all "ayers. True
%. The 1eficit 8eduction Act of 299% made com"liance "rograms #oluntary rather than mandatory. False
Check Your Understanding #($'
1. Fraudulent billings "ractices are a ma0or com"liance ris* area for healthcare organizations. True
2. A claim that is resubmitted based on a "atient com"laint is not a false claim because it !as not initiated by the
healthcare "ro#ider. False
3. +ending a du"licate claim each month to a "ayer until it is "aid is an acce"table billing "ractice. False
4. C$T codes that should not be billed together are listed in 4edicare,s Correct Coding Initiati#e. True
%. 4edicare deems all ser#ices to be medically necessary if they are ordered by a "atient,s attending "hysician.
False
Check Your Understanding #($(
1. A cor"orate code of conduct e("resses an organization,s commitment to ethical beha#ior. True
2. A cor"orate com"liance officer "osition is ideally suited to a clerical staff "erson. False
3. Federal +entencing 7uidelines encourage organizations to ha#e fraud "re#ention F detection "rograms in
"lace. True
4. Anonymous re"orting of com"liance #iolations should be "rohibited because it inhibits o"en communication.
False
%. The mission of the &ffice of the Ins"ector 7eneral for the 1e"artment of HH+ is to "rotect the integrity of
HH+ "rograms) F the health F !elfare of those "rograms, beneficiaries. True
CHA!E" #)
Check Your Understanding #)$#
17
1. The medical staff has the ultimate res"onsibility for the -uality F financial !ell2being of the health
organization. False
2. 4edical staff byla!s are considered a contract F are legally binding in most states. True
3. /oint Commission standards re-uire that the medical staff byla!s address issues of self2go#ernance F
accountability to the go#erning board. True
4. Credentialing is the "rocess of re#ie!ing and #alidating -ualifications of "ractitioners for granting medical
staff membershi". True
%. If a "ractitioner is assigned a medical staff category of 5associate)6 he or she can chair the medical staff
e(ecuti#e committee. False
Check Your Understanding #)$%
1. The "rocess for #erifying the credentials of a "hysician !ho !ishes to 0oin a medical staff is referred to as
"rimary source #erification. True
2. A healthcare organization does not ha#e a duty to share info on a "ractitioner u"on legitimate re-uest. False
3. The 3ational $ractitioner 1ata ;an* enables a healthcare facility to chec* on the bac*ground of a "ractitioner
to determine if the "ractitioner has had his or her license to "ractice sus"ended for any reason. True
4. An ad#erse action against a "hysician is not re"ortable to the 3ational $ractitioner 1ata ;an*. False
%. 1ue "rocess is re-uired in the hiring F disci"linary "rocess that affects a "ractitioner,s medical staff "ri#ileges
or em"loyment. True
CHA!E" #*
Check Your Understanding #*$#
1. The &C enforces la!s that "rotect the em"loyer from "oor 0ob a""licants. False
2. The Age 1iscrimination in m"loyment Act of 1@:G "rotects indi#iduals 49 years F older from being
discriminated against in the em"loyment setting. True
3. If an em"loyee disco#ers he is carrying the gene that causes colon cancer his insurance com"any can deny him
insurance. False
4. A hos"ital has the right to deny em"loyment to an a""licant from another country if the a""licant does not
s"ea* nglish. False
%. m"loyers must handle the conditions of "regnancy F childbirth) or related medical conditions) in the same
manner as they handle medical conditions afford an indi#idual !ho is not "regnant. True
Check Your Understanding #*$%
1. The number of hours a child under the age of 1: is "rotected by la!. True
2. 8I+A refers to "ension "lans !hile C&;8A refers to health insurance. True
3. m"loyees may not self2select to 0oin a union. False
4. <abor unions e(ist to "rotect em"loyers from demanding em"loyees. False
%. Hos"ital em"loyers must "ro#ide healthcare !or*ers !ith information regarding !hat to do if the !or*er is
accidently stic* !ith a needle that has been used on a "atient. True
18