DPT Professional Ethics & Healthcare Management 3 — Questions and Answers
Question 1: A PT employed by a physician-owned clinic suspects the physician is self-referring patients inappropriately. Which federal law most directly governs this concern?
- The False Claims Act
- The Stark Law (Physician Self-Referral Law) (Correct answer)
- The Anti-Kickback Statute
- HIPAA Privacy Rule
Correct answer: The Stark Law (Physician Self-Referral Law)
The Stark Law prohibits physician self-referrals for designated health services, including physical therapy, to entities in which the physician has a financial relationship.
Question 2: Which reimbursement model incentivizes providers to deliver the highest volume of services regardless of patient outcomes?
- Capitation
- Fee-for-service (Correct answer)
- Bundled payment
- Value-based purchasing
Correct answer: Fee-for-service
Fee-for-service reimburses per unit of service delivered, creating financial incentives to increase volume rather than optimize outcomes.
Question 3: A PT is treating a Medicare patient and determines that further skilled PT is no longer medically necessary. The patient requests to continue. The PT must:
- Continue services as long as the patient pays out-of-pocket after issuing an ABN (Correct answer)
- Continue services and bill Medicare since the patient wants them
- Discharge the patient immediately without any further discussion
- Provide a written ABN only if the patient is over age 80
Correct answer: Continue services as long as the patient pays out-of-pocket after issuing an ABN
When Medicare coverage ends, PTs may continue treating if they issue an Advance Beneficiary Notice (ABN) and the patient agrees to self-pay.
Question 4: A PT ethically discloses a financial relationship with a durable medical equipment company to patients. This practice reflects which ethical principle?
- Nonmaleficence
- Justice
- Veracity (Correct answer)
- Beneficence
Correct answer: Veracity
Veracity, the duty to be truthful, requires PTs to disclose potential conflicts of interest, including financial relationships that could bias recommendations.
Question 5: In a value-based care model, which metric would BEST measure a physical therapy department's contribution to organizational goals?
- Number of patient visits per day
- Patient functional outcome scores and readmission rates (Correct answer)
- Gross revenue generated per PT
- Average session duration
Correct answer: Patient functional outcome scores and readmission rates
Value-based care emphasizes patient outcomes and reduced hospitalizations over volume metrics, making functional outcomes and readmission rates the most relevant measures.
Question 6: A PT receives a gift from a grateful patient worth $75. According to APTA ethical guidelines, the PT should:
- Accept it freely as a token of appreciation since it is not cash
- Use professional judgment; modest gifts are generally acceptable but should not influence care (Correct answer)
- Immediately decline all gifts regardless of value to avoid any appearance of impropriety
- Accept only if the patient has been formally discharged from care
Correct answer: Use professional judgment; modest gifts are generally acceptable but should not influence care
APTA guidance allows acceptance of modest gifts using professional judgment, provided they do not influence clinical decisions or create inappropriate obligations.
Question 7: Which scenario BEST illustrates a conflict of interest in physical therapy practice?
- A PT who treats patients of all insurance types including Medicaid
- A PT who owns a supplement company and recommends those products to patients (Correct answer)
- A PT who provides pro bono services to underserved patients
- A PT who treats family members with full disclosure
Correct answer: A PT who owns a supplement company and recommends those products to patients
Owning a supplement business while recommending those products to patients creates a direct financial conflict of interest that may compromise objective clinical judgment.
DPT Professional Ethics & Healthcare Management 3
A PT employed by a physician-owned clinic suspects the physician is self-referring patients inappropriately.
Which federal law most directly governs this concern?