CCMC - Commission for Case Manager Ethical and Legal Standards Questions and Answers

Question 1

A case manager working for a managed care organization identifies that the most clinically appropriate post-acute facility for a client is out-of-network.
The organization has a strict policy to use only in-network providers to control costs.
This situation places the case manager in direct conflict between which two ethical obligations?

Accepted Answer

Client advocacy and fiduciary duty to the employer

Answer

Professional integrity and veracity

Answer

Beneficence and nonmaleficence

Answer

Confidentiality and professional competence

Question 2

A case manager receives a phone call from a client's adult son, who is requesting specific details about his father's recent diagnosis and treatment plan. The client's record does not list the son on the release of information form. According to the Health Insurance Portability and Accountability Act (HIPAA), what is the case manager's MOST appropriate response?

Accepted Answer

Inform the son that a signed authorization from the client is required before sharing information.

Answer

Provide only general information about the client's condition.

Answer

Ask the client to provide verbal consent over the phone at that moment.

Answer

Share the information, as it is reasonable to infer the son is involved in his father's care.

Question 3

Which of the following is a key requirement for healthcare facilities under the Patient Self-Determination Act (PSDA) of 1990?

Accepted Answer

Informing adult patients of their right to make healthcare decisions, including the right to formulate an advance directive.

Answer

Ensuring every admitted patient completes an advance directive.

Answer

Appointing a healthcare proxy for any patient who does not have one.

Answer

Reporting all end-of-life decisions to a state regulatory agency.

Question 4

A client offers a case manager a valuable gift certificate to a fine dining restaurant as a thank you for excellent service. According to the CCMC Code of Professional Conduct, what is the most appropriate action for the case manager to take?

Accepted Answer

Politely decline the gift, explaining that professional ethics prevent accepting gifts to avoid potential conflicts of interest.

Answer

Accept the gift to avoid offending the client and preserve the therapeutic relationship.

Answer

Accept the gift but report it to a supervisor to ensure transparency.

Answer

Suggest the client make a donation to a charity of the case manager's choice instead.

Question 5

A case manager is discussing a new, complex treatment option with a client that has significant potential benefits but also serious risks. The ethical principle of veracity is BEST demonstrated by:

Accepted Answer

providing a full, honest, and balanced explanation of both the potential benefits and the serious risks.

Answer

ensuring the client has transportation to the new treatment facility.

Answer

focusing primarily on the positive outcomes to encourage the client's hopefulness.

Answer

documenting the conversation accurately in the client's medical record.

Question 6

To avoid the legal and ethical issue of client abandonment when closing a case, which of the following is the MOST critical action for a case manager?

Accepted Answer

Ensuring the client has a safe discharge plan and knowledge of how to access future resources.

Answer

Documenting the case closure reason in the client's file.

Answer

Notifying the client's insurance company that services are ending.

Answer

Obtaining the client's signature on a service termination form.