Healthcare Policy & Legislation Flashcards

Which federal law primarily governs the privacy and security of protected health information (PHI) in the United States?

Answer: Health Insurance Portability and Accountability Act (HIPAA)

HIPAA established national standards for protecting PHI and governs how covered entities and business associates handle patient information.

Under the Affordable Care Act (ACA), what is the primary purpose of the Independent Payment Advisory Board (IPAB)?

Answer: To propose Medicare spending reductions when growth exceeds targets

The IPAB was designed to recommend Medicare spending cuts when per-capita growth exceeded a defined threshold, keeping cost growth in check.

EMTALA requires hospitals with emergency departments to:

Answer: Provide a medical screening exam and stabilize any emergency condition regardless of ability to pay

EMTALA mandates that covered hospitals screen and stabilize patients with emergency conditions without regard to insurance status or ability to pay.

Which of the following best describes the role of the Centers for Medicare & Medicaid Services (CMS) in healthcare policy?

Answer: CMS administers Medicare, Medicaid, CHIP, and oversees health insurance market standards

CMS is the federal agency responsible for administering Medicare, Medicaid, CHIP, and implementing ACA insurance market rules.

The False Claims Act (FCA) is primarily used in healthcare to address:

Answer: Fraudulent billing and false claims submitted to government healthcare programs

The FCA imposes liability on individuals and companies that submit fraudulent claims for payment to federal healthcare programs like Medicare and Medicaid.

Which federal program provides health coverage to low-income individuals and families and is jointly funded by states and the federal government?

Answer: Medicaid

Medicaid is a joint federal-state program that provides health coverage to eligible low-income adults, children, pregnant women, elderly, and people with disabilities.

The HITECH Act of 2009 strengthened HIPAA by:

Answer: Increasing penalties for HIPAA violations and expanding breach notification requirements

HITECH significantly increased civil and criminal penalties for HIPAA violations and introduced mandatory breach notification rules for covered entities and business associates.