HAC Healthcare Policy & Legislation 3

Question 1

Which federal agency is responsible for enforcing HIPAA Privacy and Security Rules?

Accepted Answer

Office for Civil Rights (OCR) within the Department of Health and Human Services

Answer

Centers for Medicare & Medicaid Services (CMS)

Answer

Office of Inspector General (OIG)

Answer

Food and Drug Administration (FDA)

Question 2

A healthcare organization's compliance program should include all of the following elements recommended by the OIG EXCEPT:

Accepted Answer

Guaranteed immunity from federal prosecution for all compliance violations discovered internally

Answer

Written policies and procedures addressing specific compliance risks

Answer

Designation of a compliance officer and compliance committee

Answer

Regular training and education for all employees

Question 3

Under HIPAA's Minimum Necessary standard, covered entities must:

Accepted Answer

Limit the use and disclosure of PHI to the minimum amount needed to accomplish the intended purpose

Answer

Disclose all available patient health information when requested by any authorized provider

Answer

Obtain written authorization for any disclosure of PHI, without exception

Answer

Share complete medical records whenever treatment continuity requires coordination of care

Question 4

The Balanced Budget Act of 1997 significantly affected Medicare by:

Accepted Answer

Creating the Medicare+Choice program (later renamed Medicare Advantage) and introducing prospective payment for home health

Answer

Expanding Medicare to cover adults under 65 with chronic conditions

Answer

Establishing mandatory managed care enrollment for all Medicare beneficiaries

Answer

Eliminating cost-sharing requirements for Medicare Part A hospital stays

Question 5

Which of the following best describes 'value-based purchasing' in CMS payment reform?

Accepted Answer

Tying a portion of provider reimbursement to quality and efficiency metrics rather than paying purely for volume of services

Answer

Requiring hospitals to purchase medical supplies from vendors with lowest-cost contracts

Answer

Incentivizing patients to choose lower-cost providers by reducing their cost-sharing

Answer

Mandating that health plans purchase reinsurance for high-cost claims

Question 6

The Children's Health Insurance Program (CHIP) is designed to provide coverage to:

Accepted Answer

Children in families with incomes too high for Medicaid but who cannot afford private insurance

Answer

All children under age 18 regardless of family income

Answer

Children of federal government employees not covered under FEHB

Answer

Uninsured children in foster care transitioning to adult coverage

Question 7

The No Surprises Act, effective January 2022, primarily protects patients from:

Accepted Answer

Unexpected out-of-network charges for emergency care and certain non-emergency services at in-network facilities

Answer

Fraudulent billing practices by durable medical equipment suppliers

Answer

Unannounced increases in monthly health insurance premiums

Answer

Surprise prescription drug cost increases at point of sale