Medical Ethics, Legal and Regulatory Issues 1 Flashcards

A patient scheduled for cataract surgery tells the ophthalmic technician they are unsure whether they want to proceed and have not signed the consent form. The surgeon is ready to begin. What is the most appropriate action for the technician?

Answer: Notify the surgeon that the patient has not consented and is uncertain

Informed consent must be obtained voluntarily before any procedure. The technician's duty is to halt preparation and notify the surgeon so the patient can have their questions addressed and consent obtained properly. Proceeding without consent violates patient rights and exposes the facility to legal liability.

Under HIPAA, which of the following is permissible without obtaining specific patient authorization?

Answer: Discussing a patient's treatment with another physician directly involved in their care

HIPAA's Treatment, Payment, and Healthcare Operations (TPO) provisions allow protected health information to be shared among treating providers without additional authorization. The other options require explicit patient authorization or fall outside permitted disclosures.

A COT discovers that a colleague has been billing for ancillary tests that were ordered but never actually performed. What is the ethically and legally correct response?

Answer: Report the fraudulent billing through appropriate channels, such as a supervisor or compliance officer

Billing for services not rendered constitutes healthcare fraud under federal law (False Claims Act). COTs have both an ethical and legal obligation to report suspected fraud through proper channels. Ignoring or delaying reporting can make the observer complicit in the fraud.

A 16-year-old patient presents alone for a routine vision examination. The parent has signed a general consent for care on file. The technician is asked to perform corneal topography, a test not typically included in a routine exam. What is the best course of action?

Answer: Contact a parent or guardian to obtain consent for the additional procedure

A minor generally cannot provide legally binding consent for medical procedures except in specific circumstances (e.g., emancipated minors, emergency care). A general consent on file does not cover additional unanticipated procedures. The appropriate step is to obtain parental or guardian consent before proceeding.

Which federal law specifically governs the privacy and security of electronically transmitted patient health information in ophthalmology practices?

Answer: The Health Insurance Portability and Accountability Act (HIPAA)

HIPAA establishes national standards for protecting individually identifiable health information, including electronic health records and transmissions. The HIPAA Privacy and Security Rules directly govern how ophthalmology practices must handle, store, and transmit patient data.

A patient requests a copy of their complete medical record, including images from their retinal photography session. The office manager tells the COT to only provide the written notes, not the images, to save copying costs. What should the COT understand about this situation?

Answer: Patients have the right under HIPAA to access their complete designated record set, which includes diagnostic images

Under HIPAA, patients have the right to access their 'designated record set,' which includes all records used to make decisions about care, including diagnostic images such as retinal photographs. Withholding portions of the record to reduce costs is not a valid reason for denial and could violate federal patient rights regulations.