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
Under HIPAA's Breach Notification Rule, covered entities must notify affected individuals of an unsecured PHI breach within:
Answer: 60 days
The HIPAA Breach Notification Rule requires covered entities to notify affected individuals without unreasonable delay and no later than 60 days after discovery.
The Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals to:
Answer: Screen and stabilize any patient who presents to the emergency department
EMTALA mandates that hospitals with emergency departments perform a medical screening exam and stabilize patients with emergency medical conditions, regardless of ability to pay.
The Stark Law (Physician Self-Referral Law) prohibits physicians from referring Medicare patients to entities for designated health services if:
Answer: The physician has a financial relationship with that entity
The Stark Law prohibits physician self-referrals to entities where the physician or an immediate family member has a financial relationship, unless a specific exception applies.
Which of the following is an example of 'upcoding' in medical billing?
Answer: Billing a higher-level service than was actually provided
Upcoding involves billing for a more complex or expensive service than was actually provided, which constitutes healthcare fraud.
A covered entity's Notice of Privacy Practices (NPP) must be provided to new patients:
Answer: No later than the first date of service
Under HIPAA, covered entities must make a good faith effort to provide the NPP to patients no later than the first date of service and obtain written acknowledgment.
Which law established the Health Insurance Marketplace and required most Americans to obtain health insurance coverage?
Answer: The Affordable Care Act (ACA)
The Affordable Care Act (ACA) of 2010 established Health Insurance Marketplaces, expanded Medicaid, and introduced the individual mandate requiring most Americans to obtain coverage.
Under OSHA's Bloodborne Pathogens Standard, employers must offer hepatitis B vaccination to at-risk employees:
Answer: At no cost, within 10 working days of initial assignment
OSHA's Bloodborne Pathogens Standard requires employers to offer hepatitis B vaccination to occupationally at-risk employees at no cost within 10 working days of initial assignment.