BHP Ethical & Legal Standards in Behavioral Health 2 — Questions and Answers
Question 1: A BHP discovers that a colleague is billing Medicaid for services never rendered. The most appropriate first action is to:
- Confront the colleague privately and demand they stop
- Report the fraud to the appropriate oversight body or supervisor (Correct answer)
- Document the behavior and wait to see if it continues
- Ignore it to avoid workplace conflict
Correct answer: Report the fraud to the appropriate oversight body or supervisor
Billing fraud against government programs must be reported to supervisors or appropriate authorities such as a compliance officer or state licensing board.
Question 2: Under HIPAA, a covered entity may disclose protected health information (PHI) without client authorization for which of the following?
- Marketing purposes with business associate consent
- Treatment, payment, and healthcare operations (Correct answer)
- Research studies without an IRB waiver
- Employer requests for productivity assessment
Correct answer: Treatment, payment, and healthcare operations
HIPAA permits disclosure of PHI without authorization for treatment, payment, and healthcare operations (TPO).
Question 3: A client discloses they have a communicable disease and refuses to inform their partner. The BHP's ethical obligation is BEST described as:
- Always maintain confidentiality regardless of risk to others
- Consider state law, weigh public health duty, and potentially warn partner if legally permitted (Correct answer)
- Immediately disclose to the partner without further assessment
- Terminate services until the client notifies their partner
Correct answer: Consider state law, weigh public health duty, and potentially warn partner if legally permitted
Many states have statutes permitting or requiring disclosure to protect third parties from communicable disease; the BHP must know applicable law and weigh the duty to warn.
Question 4: Which of the following BEST defines 'informed consent' in behavioral health treatment?
- A signed form indicating the client read a policy document
- A process ensuring clients understand the nature, risks, benefits, and alternatives to treatment before agreeing (Correct answer)
- Verbal agreement to attend the first session
- The therapist explaining treatment goals at the end of the intake
Correct answer: A process ensuring clients understand the nature, risks, benefits, and alternatives to treatment before agreeing
Informed consent is an ongoing process requiring client understanding of treatment nature, risks, benefits, and alternatives, not merely a signature.
Question 5: A BHP working with a minor (age 15) learns that the teenager is using marijuana recreationally. Regarding parental notification, the BHP should:
- Notify parents immediately as minors have no confidentiality rights
- Consult state law, assess risk level, and use clinical judgment about whether disclosure is warranted (Correct answer)
- Never disclose because adolescents have full confidentiality rights
- Discharge the client for substance use
Correct answer: Consult state law, assess risk level, and use clinical judgment about whether disclosure is warranted
Minors' confidentiality rights vary by state, and BHPs must use clinical judgment informed by state law when deciding whether to notify parents about a minor's substance use.
Question 6: Which of the following is an example of a dual relationship that would most clearly violate ethical standards?
- Treating a client who is also a member of the BHP's church congregation
- Providing therapy to a current employee under the BHP's direct supervision (Correct answer)
- Acknowledging a former client at a community event
- Attending a client's graduation at the client's request
Correct answer: Providing therapy to a current employee under the BHP's direct supervision
Providing therapy to a direct employee creates a power imbalance and conflicting obligations that compromise objectivity and constitute a clear dual relationship violation.
Question 7: A BHP receives a subpoena for a client's therapy records. The correct course of action is to:
- Release records immediately to comply with the court order
- Notify the client, consult with legal counsel, and assert privilege on the client's behalf if applicable (Correct answer)
- Refuse all legal requests as confidentiality is absolute
- Redact all diagnoses and release the remaining records
Correct answer: Notify the client, consult with legal counsel, and assert privilege on the client's behalf if applicable
A subpoena is not a court order; the BHP should notify the client, consult legal counsel, and assert therapist-client privilege unless a judge orders disclosure.
BHP Ethical & Legal Standards in Behavioral Health 2
A BHP discovers that a colleague is billing Medicaid for services never rendered.
The most appropriate first action is to: