NP Regulatory Frameworks & Compliance 5 — Questions and Answers
Question 1: A malpractice lawsuit against an NP requires the plaintiff to prove four elements. Which element requires showing that the NP's actions directly caused the patient's harm?
- Duty
- Breach
- Causation (Correct answer)
- Damages
Correct answer: Causation
Causation (specifically proximate cause) is the element requiring proof that the NP's breach of the standard of care was a direct cause of the patient's injury or harm.
Question 2: The Health Insurance Portability and Accountability Act (HIPAA) Security Rule applies specifically to:
- All forms of PHI including paper records and verbal communications
- Electronic Protected Health Information (ePHI) only (Correct answer)
- PHI stored on-site but not PHI transmitted electronically
- Only PHI held by insurance companies, not providers
Correct answer: Electronic Protected Health Information (ePHI) only
The HIPAA Security Rule specifically addresses the protection of electronic Protected Health Information (ePHI), while the Privacy Rule covers PHI in all formats.
Question 3: An NP working in a federally qualified health center (FQHC) benefits from which federal liability protection?
- The Federal Tort Claims Act (FTCA) (Correct answer)
- The Good Samaritan Law
- The Anti-Kickback Safe Harbor
- The National Practitioner Data Bank immunity
Correct answer: The Federal Tort Claims Act (FTCA)
NPs employed by FQHCs are deemed federal employees and are covered under the Federal Tort Claims Act, which provides malpractice liability protection through the federal government.
Question 4: Which of the following represents a required element for valid informed consent?
- The patient must sign a consent form witnessed by a notary public
- The patient must be informed of the risks, benefits, alternatives, and consequences of refusing treatment (Correct answer)
- A family member must co-sign the consent for any invasive procedure
- Consent must be obtained at least 24 hours before any elective procedure
Correct answer: The patient must be informed of the risks, benefits, alternatives, and consequences of refusing treatment
Valid informed consent requires disclosing the nature of the procedure, its risks and benefits, available alternatives, and the consequences of refusing, in terms the patient can understand.
Question 5: Under federal law, which patients are protected by the Mental Health Parity and Addiction Equity Act (MHPAEA)?
- Only Medicaid recipients with a documented psychiatric diagnosis
- Patients in health plans that offer mental health benefits, requiring parity with medical/surgical benefits (Correct answer)
- Medicare Part A beneficiaries admitted for inpatient psychiatric care only
- Uninsured patients seeking outpatient mental health services
Correct answer: Patients in health plans that offer mental health benefits, requiring parity with medical/surgical benefits
MHPAEA requires health plans that offer mental health and substance use disorder benefits to provide coverage no more restrictive than coverage for medical and surgical conditions.
Question 6: The National Practitioner Data Bank (NPDB) is queried by hospitals when credentialing NPs primarily to identify:
- An NP's current DEA registration status
- Malpractice payments and adverse licensure or privileging actions taken against the NP (Correct answer)
- An NP's board certification examination scores
- Criminal background check results from state law enforcement databases
Correct answer: Malpractice payments and adverse licensure or privileging actions taken against the NP
The NPDB contains reports of malpractice payments, adverse licensure actions, hospital privilege revocations, and other adverse actions, which hospitals must query during the credentialing process.
Question 7: A telehealth NP licensed in State A provides a video visit to a patient who is physically located in State B at the time of the visit. For regulatory compliance, the NP must:
- Only maintain licensure in State A, the NP's home state
- Hold a valid license in State B, where the patient is located, to practice across state lines (Correct answer)
- Register with the DEA in both states but only needs one state license
- Obtain a temporary federal telehealth waiver for each cross-state encounter
Correct answer: Hold a valid license in State B, where the patient is located, to practice across state lines
Telehealth practice is generally regulated by the state where the patient is physically located at the time of the visit, requiring the NP to hold licensure in that state.
NP Regulatory Frameworks & Compliance 5
A malpractice lawsuit against an NP requires the plaintiff to prove four elements.
Which element requires showing that the NP's actions directly caused the patient's harm?