Quality Assurance & Compliance Flashcards
7 cards from real CAS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Quality Assurance & Compliance flashcards as text
Which of the following scenarios would constitute a breach under HIPAA's Breach Notification Rule?
Answer: An unencrypted email containing client PHI is accidentally sent to the wrong recipient
Sending unencrypted PHI to an unauthorized recipient constitutes a breach requiring notification under HIPAA.
A CAS candidate is reviewing their agency's accreditation standards. Which organization specifically accredits opioid treatment programs (OTPs) at the federal level?
Answer: SAMHSA-approved accrediting bodies
Federal law (42 CFR Part 8) requires OTPs to be accredited by a SAMHSA-approved accreditation body, such as CARF or The Joint Commission.
In quality assurance, a 'sentinel event' is best defined as:
Answer: An unexpected occurrence involving death or serious physical or psychological harm
A sentinel event is a serious, often unexpected event (such as client death or serious injury) that requires thorough root cause analysis.
When conducting a root cause analysis (RCA) after a sentinel event, the primary goal is to:
Answer: Determine underlying systemic factors that contributed to the event
RCA focuses on identifying systemic and process failures rather than individual blame, to prevent future occurrences.
A state requires that all SUD counselors complete 6 hours of continuing education annually on ethics. This requirement is an example of:
Answer: Licensure renewal requirement
Mandatory continuing education hours for license renewal are set by state licensing boards as conditions of maintaining professional credentials.
A client's treatment is being managed by a team that includes physicians, nurses, and counselors. Under HIPAA, sharing PHI among these team members for treatment purposes:
Answer: Is permitted without authorization as part of treatment coordination
HIPAA allows covered entities to share PHI within a treatment team for care coordination without requiring patient authorization.
Which documentation element is MOST critical for demonstrating medical necessity for continued residential addiction treatment when requesting authorization from a managed care organization?
Answer: Documented clinical indicators showing why a lower level of care would be insufficient
Medical necessity documentation must demonstrate specific clinical reasons why a less intensive level of care would be clinically inadequate.