Ethical Principles and Conduct 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 Principles and Conduct flashcards as text
A case manager discovers that a client's employer-sponsored insurance plan is denying a medically necessary treatment. What is the case manager's primary ethical obligation?
Answer: Advocate for the client's right to medically necessary care
Advocacy is a core ethical duty of case managers, requiring them to actively support clients' access to medically necessary care.
Which ethical principle is BEST reflected when a case manager ensures a client fully understands the risks and benefits of a proposed treatment before agreeing to it?
Answer: Autonomy
Respecting autonomy requires that clients receive complete information to make voluntary, informed decisions about their care.
A case manager learns that a colleague is falsifying documentation to obtain insurance approvals. What should the case manager do FIRST?
Answer: Immediately report to the appropriate supervisory or regulatory authority
Falsifying documentation is fraud; the case manager's ethical and legal duty requires prompt reporting to appropriate authorities.
When a case manager works for both a health plan and provides services to its members, which ethical issue is MOST likely to arise?
Answer: Conflict of interest
Serving both the payer and the client creates a conflict of interest, as the case manager's loyalties may be divided.
A terminally ill client requests information about hospice care but family members ask the case manager to withhold this information. The case manager should:
Answer: Provide the client with the requested information, honoring their autonomy
A competent client's right to information about their own care supersedes family preferences under the autonomy principle.
Which of the following BEST describes the ethical concept of veracity in case management practice?
Answer: Being truthful and honest in all communications with clients and stakeholders
Veracity refers to the obligation to be truthful and transparent in all professional communications.
A case manager is asked by a supervisor to recommend a specific home health agency that the organization has a financial relationship with. This situation BEST represents:
Answer: A potential conflict of interest requiring disclosure
Financial relationships between an organization and a referral source create a conflict of interest that must be disclosed to clients.