CMAS Regulatory Compliance & Legal Framework 3 — Questions and Answers
Question 1: Which element is NOT required for a valid informed consent to be legally binding?
- Disclosure of the nature of the procedure and material risks
- The patient's voluntary agreement without coercion
- Witness signature from a physician other than the treating provider (Correct answer)
- Patient's competency to make the decision
Correct answer: Witness signature from a physician other than the treating provider
Valid informed consent requires disclosure, voluntariness, and patient competency, but does not legally require a witness signature from a non-treating physician.
Question 2: Under EMTALA, a hospital emergency department is required to:
- Provide a medical screening exam and stabilizing treatment to all patients regardless of ability to pay (Correct answer)
- Treat only patients who present with life-threatening conditions
- Obtain insurance verification before initiating any evaluation
- Transfer patients immediately to facilities that accept their insurance
Correct answer: Provide a medical screening exam and stabilizing treatment to all patients regardless of ability to pay
EMTALA mandates that any patient presenting to an ED must receive a medical screening examination and, if an emergency condition exists, stabilizing treatment regardless of payment status.
Question 3: Which of the following best describes the False Claims Act's 'qui tam' provision?
- A provision allowing the government to seal healthcare records during fraud investigations
- A whistleblower provision enabling private citizens to file fraud lawsuits on behalf of the government and share in the recovery (Correct answer)
- A rule requiring mandatory reporting of all billing errors to CMS
- A provision limiting the timeframe for filing Medicare fraud claims
Correct answer: A whistleblower provision enabling private citizens to file fraud lawsuits on behalf of the government and share in the recovery
The qui tam provision allows private individuals (relators) to file lawsuits alleging fraud against the government and receive a percentage of recovered funds.
Question 4: A patient with a disability requests a sign language interpreter for a medical appointment. Under the ADA, the practice must:
- Provide the interpreter at no cost to the patient as a reasonable accommodation (Correct answer)
- Charge the patient the full cost of interpreter services
- Refer the patient to a facility that specializes in disability services
- Require the patient to bring their own interpreter
Correct answer: Provide the interpreter at no cost to the patient as a reasonable accommodation
Title III of the ADA requires covered healthcare entities to provide effective communication aids, including sign language interpreters, at no charge to the patient.
Question 5: Which document grants another person legal authority to make healthcare decisions for an incapacitated patient?
- Living will
- Durable power of attorney for healthcare (healthcare proxy) (Correct answer)
- Do-Not-Resuscitate order
- Patient rights acknowledgment form
Correct answer: Durable power of attorney for healthcare (healthcare proxy)
A durable power of attorney for healthcare (or healthcare proxy) designates a specific person to make medical decisions when the patient lacks decision-making capacity.
Question 6: Under HIPAA's Minimum Necessary Standard, a medical office should:
- Share a patient's entire medical record whenever any portion is requested
- Disclose only the amount of PHI needed to accomplish the intended purpose (Correct answer)
- Require a signed release for every internal use of patient information
- Allow all staff unrestricted access to all patient records
Correct answer: Disclose only the amount of PHI needed to accomplish the intended purpose
The Minimum Necessary Standard requires covered entities to limit PHI disclosures to what is reasonably necessary to accomplish the specified purpose.
Question 7: Which federal program oversees quality and safety standards for hospital facilities receiving Medicare and Medicaid funding through a process called 'deemed status'?
- CMS through The Joint Commission or other accrediting bodies (Correct answer)
- OSHA through annual workplace inspections
- HHS through direct facility audits only
- FDA through drug and device inspections
Correct answer: CMS through The Joint Commission or other accrediting bodies
CMS grants 'deemed status' to hospitals accredited by approved organizations like The Joint Commission, meaning accreditation is accepted in lieu of direct CMS surveys.
CMAS Regulatory Compliance & Legal Framework 3
Which element is NOT required for a valid informed consent to be legally binding?