CHL Healthcare Ethics and Regulations 5 — Questions and Answers
Question 1: A hospital employee suspects a supervisor of committing Medicare fraud. The most appropriate action under federal law is to:
- Resign immediately to avoid liability
- Report findings through internal compliance channels or the OIG hotline (Correct answer)
- Confront the supervisor directly before involving anyone else
- Wait for an external audit to surface the issue
Correct answer: Report findings through internal compliance channels or the OIG hotline
Federal law protects and encourages reporting of suspected fraud through internal compliance programs or the OIG hotline, and whistleblowers have legal protections.
Question 2: When applying the ethical principle of nonmaleficence in clinical decision-making, a leader must consider:
- The patient's ability to pay for treatment
- Whether an intervention causes more harm than benefit (Correct answer)
- The provider's personal moral values
- Hospital financial performance metrics
Correct answer: Whether an intervention causes more harm than benefit
Nonmaleficence requires that clinicians avoid treatments where anticipated harm outweighs expected benefit.
Question 3: Which of the following is NOT a covered entity under HIPAA?
- A hospital billing department
- A health insurance company
- An employer receiving employee health information directly from a physician (Correct answer)
- A healthcare clearinghouse
Correct answer: An employer receiving employee health information directly from a physician
Employers who receive health information directly (not through a group health plan) are not HIPAA covered entities, though they may have other legal obligations.
Question 4: A clinical researcher fails to obtain informed consent from study participants. This violates which foundational document of research ethics?
- The Flexner Report
- The Belmont Report (Correct answer)
- The Geneva Convention
- The Hippocratic Oath
Correct answer: The Belmont Report
The Belmont Report established core principles of research ethics—respect for persons, beneficence, and justice—including the requirement for informed consent.
Question 5: A healthcare organization implementing a culture of safety should primarily focus on:
- Disciplining individuals involved in errors to deter future mistakes
- Designing systems that reduce the likelihood of human error (Correct answer)
- Limiting error reporting to senior leadership only
- Outsourcing risk management to external consultants
Correct answer: Designing systems that reduce the likelihood of human error
A safety culture recognizes that most errors are system-based and focuses on redesigning processes to prevent errors rather than blaming individuals.
Question 6: Under the Patient Self-Determination Act (PSDA), healthcare facilities receiving Medicare or Medicaid funding must:
- Provide all patients with a living will template upon admission
- Inform patients of their right to make advance directives and have those directives followed (Correct answer)
- Require patients to complete advance directives before elective procedures
- Designate a healthcare proxy for every admitted patient
Correct answer: Inform patients of their right to make advance directives and have those directives followed
The PSDA requires facilities to inform patients of their rights to make advance directives and document whether such directives exist in their records.
Question 7: Which of the following scenarios represents a conflict of interest for a hospital administrator?
- Approving a vendor contract for a company in which the administrator holds stock (Correct answer)
- Participating in a peer review of a physician from another department
- Serving on a community health advisory board without compensation
- Implementing a new electronic health record system recommended by IT staff
Correct answer: Approving a vendor contract for a company in which the administrator holds stock
A conflict of interest arises when a personal financial interest (such as stock ownership) could improperly influence an official decision-making role.
CHL Healthcare Ethics and Regulations 5
A hospital employee suspects a supervisor of committing Medicare fraud.
The most appropriate action under federal law is to: