Legal Issues Flashcards
7 cards from real CPHRM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Legal Issues flashcards as text
An advance directive executed in one state by a patient who is now hospitalized in a different state is:
Answer: Generally honored under most states' reciprocity provisions, though state law varies
Most states have provisions to honor out-of-state advance directives to the extent they comply with the originating state's law, though risk managers should know their specific state's rules.
The Anti-Kickback Statute prohibits knowingly and willfully offering, paying, soliciting, or receiving anything of value to induce or reward referrals of items or services covered by:
Answer: Federal healthcare programs such as Medicare and Medicaid
The Anti-Kickback Statute applies to Federal healthcare program business, primarily Medicare and Medicaid, and violations can result in criminal penalties and exclusion from federal programs.
A 'never event' in the context of risk management and CMS policy refers to:
Answer: A serious, preventable adverse event for which CMS does not provide additional payment
CMS designates certain serious preventable adverse events as 'never events' (Hospital-Acquired Conditions) for which it will not provide additional reimbursement, incentivizing prevention.
Under HIPAA's Breach Notification Rule, a covered entity must notify affected individuals of a breach of unsecured PHI within:
Answer: No more than 60 days of discovery
HIPAA requires covered entities to notify affected individuals without unreasonable delay and no later than 60 calendar days after discovery of a breach of unsecured PHI.
A patient signs a general consent for treatment upon hospital admission. For a surgical procedure, this general consent:
Answer: Is sufficient only for routine nursing care; surgery requires specific informed consent
A general admission consent covers routine care, but procedures like surgery require a separate, specific informed consent process that includes risks, benefits, alternatives, and questions.
A risk manager is reviewing a case where a patient alleges assault and battery by a healthcare provider. Battery in a medical context most commonly occurs when:
Answer: A procedure is performed without the patient's consent
Medical battery occurs when a provider intentionally makes harmful or offensive contact with a patient without consent, most commonly by performing an unauthorized procedure.
When managing a potentially compensable event (PCE), the risk manager's early intervention with the patient and family is primarily aimed at:
Answer: Building trust, gathering facts, and reducing the likelihood of litigation through transparent communication
Early intervention in PCEs focuses on open communication, expressing empathy, conducting early fact-finding, and addressing patient/family needs, which research shows reduces the frequency and severity of malpractice claims.