CCM Ethics, Advocacy, & Legal Issues 5

Question 1

A case manager who works for a managed care organization is also doing private consulting for a drug company. This situation most likely represents:

Accepted Answer

A dual relationship and potential conflict of interest

Answer

Simultaneously working for a managed care organization and consulting for a pharmaceutical company creates a dual relationship with potential conflicts of interest.

Question 2

The 'best interest standard' is applied in surrogate decision-making when:

Accepted Answer

The patient's previously expressed wishes are unknown

Answer

The best interest standard guides surrogates to decide what a reasonable person would want when the patient's own wishes are not known.

Question 3

Which legislative act requires group health plans to provide mental health and substance use disorder benefits comparable to medical/surgical benefits?

Accepted Answer

Mental Health Parity and Addiction Equity Act (MHPAEA)

Answer

MHPAEA mandates that mental health and substance use disorder coverage be no more restrictive than medical and surgical coverage in group health plans.

Question 4

A case manager overhears a physician providing inaccurate information to a client about their prognosis. The most ethical response is to:

Accepted Answer

Speak privately with the physician and advocate for accurate client education

Answer

Addressing misinformation through private communication with the physician is the most constructive and professionally appropriate first response.

Question 5

Which of the following is an example of 'therapeutic privilege' and is generally considered ethically problematic?

Accepted Answer

Withholding a terminal diagnosis from a client because the provider fears it will cause distress

Answer

Therapeutic privilege — withholding information to prevent distress — undermines informed consent and is widely considered ethically unjustifiable.

(CCM) Certified Care Manager Practice Test

(CCM) Certified Care Manager Practice Test

CCM Ethics, Advocacy, & Legal Issues 5