CHL Law and Ethics 2 — Questions and Answers
Question 1: A patient refuses a blood transfusion on religious grounds despite life-threatening blood loss. What is the healthcare leader's primary obligation?
- Override the refusal to save the patient's life
- Document the refusal and respect the competent patient's decision (Correct answer)
- Seek a court order immediately
- Transfer the patient to another facility without discussion
Correct answer: Document the refusal and respect the competent patient's decision
Competent adults have the legal and ethical right to refuse any medical treatment, including life-saving transfusions, and this must be documented and respected.
Question 2: Which federal law governs the privacy and security of electronically protected health information (ePHI)?
- EMTALA
- HIPAA Security Rule (Correct answer)
- Stark Law
- False Claims Act
Correct answer: HIPAA Security Rule
The HIPAA Security Rule specifically establishes national standards for protecting electronically protected health information.
Question 3: Under the Emergency Medical Treatment and Labor Act (EMTALA), a hospital with an emergency department must:
- Admit all patients who request inpatient care
- Provide a medical screening exam to anyone who presents, regardless of ability to pay (Correct answer)
- Transfer unstable patients to reduce liability
- Require insurance verification before initiating emergency care
Correct answer: Provide a medical screening exam to anyone who presents, regardless of ability to pay
EMTALA requires hospitals to provide a medical screening exam and stabilizing treatment to all individuals who present to the ED regardless of their insurance or ability to pay.
Question 4: A healthcare leader discovers that a physician is self-referring patients to a laboratory in which the physician has a financial interest. This likely violates which law?
- Anti-Kickback Statute only
- Stark Law (Physician Self-Referral Law) (Correct answer)
- EMTALA
- COBRA
Correct answer: Stark Law (Physician Self-Referral Law)
The Stark Law prohibits physicians from referring Medicare/Medicaid patients to entities with which they have a financial relationship, unless a specific exception applies.
Question 5: Which ethical principle is most directly applied when a clinician discloses the risks and benefits of a procedure to a patient before obtaining their signature?
- Justice
- Beneficence
- Informed consent / Autonomy (Correct answer)
- Nonmaleficence
Correct answer: Informed consent / Autonomy
Informed consent operationalizes autonomy by ensuring patients have adequate information to make voluntary, knowledgeable decisions about their care.
Question 6: An employee reports suspected Medicare fraud to a federal agency and is subsequently terminated. Which law most directly protects this employee?
- Title VII of the Civil Rights Act
- False Claims Act whistleblower provisions (Correct answer)
- OSHA General Duty Clause
- National Labor Relations Act
Correct answer: False Claims Act whistleblower provisions
The False Claims Act contains anti-retaliation (whistleblower) provisions that protect employees who report fraud against federal healthcare programs.
Question 7: A hospital's compliance committee is reviewing a potential Anti-Kickback Statute issue. Which element is essential to establish a violation?
- The arrangement must involve a publicly traded company
- There must be intent to induce referrals of federally reimbursed services (Correct answer)
- The physician must have been disciplined previously
- The amount exchanged must exceed $10,000
Correct answer: There must be intent to induce referrals of federally reimbursed services
The Anti-Kickback Statute requires proof of intent — that remuneration was knowingly offered or paid to induce or reward referrals of items or services covered by federal healthcare programs.
CHL Law and Ethics 2
A patient refuses a blood transfusion on religious grounds despite life-threatening blood loss.
What is the healthcare leader's primary obligation?