Ethical & Legal Issues in Care Management Flashcards
7 cards from real CCM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Ethical & Legal Issues in Care Management flashcards as text
Under HIPAA, which category of information is protected from unauthorized disclosure?
Answer: Protected Health Information (PHI) in any form
HIPAA protects PHI in all forms — electronic, written, and oral — from unauthorized disclosure.
A care manager may legally share a patient's health information without explicit written authorization when it is for:
Answer: Treatment, payment, or healthcare operations (TPO)
HIPAA permits disclosure of PHI without specific patient authorization for treatment, payment, and healthcare operations purposes.
A patient's right to access and receive copies of their own medical records is primarily protected under:
Answer: HIPAA's Privacy Rule
HIPAA's Privacy Rule grants patients the right to inspect, access, and obtain copies of their own protected health information.
In which situation is a care manager legally REQUIRED to breach patient confidentiality?
Answer: When there is a credible threat of harm to an identifiable third party
The duty to warn requires care managers to breach confidentiality when a patient poses a credible, specific threat of harm to an identifiable third party.
For informed consent to be legally and ethically valid, the patient must:
Answer: Understand the proposed plan, its risks, benefits, and alternatives
Valid informed consent requires that patients receive, comprehend, and voluntarily agree to information about the proposed plan including its risks, benefits, and alternatives.
When a patient has been determined to lack decision-making capacity, healthcare decisions should be made by:
Answer: A legally designated surrogate acting in the patient's best interest
When a patient lacks capacity, a legally designated surrogate or proxy makes decisions based on the patient's previously expressed wishes or best interests.
Which legal document allows a competent patient to specify their healthcare wishes in the event they become incapacitated?
Answer: A living will or advance directive
An advance directive or living will is a legal document completed while the patient has capacity that specifies their healthcare preferences for future incapacity.