Ethics, Advocacy, & Legal Issues 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 Ethics, Advocacy, & Legal Issues flashcards as text
A case manager who works for a managed care organization is also doing private consulting for a drug company. This situation most likely represents:
Answer: A dual relationship and potential conflict of interest
Simultaneously working for a managed care organization and consulting for a pharmaceutical company creates a dual relationship with potential conflicts of interest.
The 'best interest standard' is applied in surrogate decision-making when:
Answer: The patient's previously expressed wishes are unknown
The best interest standard guides surrogates to decide what a reasonable person would want when the patient's own wishes are not known.
Which legislative act requires group health plans to provide mental health and substance use disorder benefits comparable to medical/surgical benefits?
Answer: Mental Health Parity and Addiction Equity Act (MHPAEA)
MHPAEA mandates that mental health and substance use disorder coverage be no more restrictive than medical and surgical coverage in group health plans.
A case manager overhears a physician providing inaccurate information to a client about their prognosis. The most ethical response is to:
Answer: Speak privately with the physician and advocate for accurate client education
Addressing misinformation through private communication with the physician is the most constructive and professionally appropriate first response.
Which of the following is an example of 'therapeutic privilege' and is generally considered ethically problematic?
Answer: Withholding a terminal diagnosis from a client because the provider fears it will cause distress
Therapeutic privilege — withholding information to prevent distress — undermines informed consent and is widely considered ethically unjustifiable.
A case manager working with a culturally diverse population should PRIMARILY:
Answer: Assess and incorporate each client's cultural values and beliefs into care planning
Culturally competent care requires assessing and integrating each client's unique cultural context into individualized care planning.
A client asks a case manager to falsify documentation to help obtain a benefit. The case manager should:
Answer: Refuse and explain that falsification is illegal and unethical
Falsifying documentation is fraud — both illegal and a serious ethical violation — regardless of the client's perceived need.