Healthcare Regulations & Compliance Flashcards
7 cards from real NHI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Healthcare Regulations & Compliance flashcards as text
Which federal law prohibits healthcare providers from knowingly submitting false claims to Medicare or Medicaid?
Answer: False Claims Act
The False Claims Act (FCA) imposes liability on individuals and companies who defraud the federal government by submitting false or fraudulent claims for payment.
A patient requests an amendment to their medical record, claiming an entry is inaccurate. Under HIPAA, the covered entity must respond within how many days?
Answer: 60 days
HIPAA requires covered entities to respond to amendment requests within 60 days, with a possible 30-day extension if notice is provided.
Which organization accredits hospitals and healthcare organizations and has 'deemed status' from CMS for Medicare certification?
Answer: The Joint Commission (TJC)
The Joint Commission holds deemed status from CMS, meaning TJC-accredited facilities are considered to meet Medicare Conditions of Participation.
Under the Occupational Safety and Health Act, employers must provide a workplace free from recognized hazards under which doctrine?
Answer: General Duty Clause
The General Duty Clause of the OSH Act requires employers to provide a workplace free from recognized hazards likely to cause death or serious physical harm.
A healthcare worker accidentally views a celebrity patient's records out of curiosity without a clinical reason. This is best described as:
Answer: A HIPAA privacy violation
Accessing a patient's PHI without a legitimate work-related reason violates the HIPAA minimum necessary standard and constitutes a privacy violation.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) primarily protects employees by:
Answer: Allowing continuation of group health insurance after leaving employment
COBRA allows employees and their dependents to continue group health insurance coverage for a limited period after losing employment or experiencing other qualifying events.
Which regulatory body enforces workplace safety standards and investigates work-related injuries and illnesses in healthcare settings?
Answer: OSHA
The Occupational Safety and Health Administration (OSHA) enforces workplace safety standards, including bloodborne pathogen standards critical to healthcare settings.