MHA Health Law and Regulations 2 — Questions and Answers
Question 1: Under the Emergency Medical Treatment and Labor Act (EMTALA), which action constitutes an illegal 'patient dumping'?
- Transferring a stabilized patient to a facility better equipped for long-term care
- Refusing to perform a medical screening exam on a patient who cannot pay (Correct answer)
- Discharging a patient who voluntarily leaves against medical advice
- Sending a patient to a specialist with proper documentation
Correct answer: Refusing to perform a medical screening exam on a patient who cannot pay
EMTALA prohibits hospitals from refusing a medical screening examination or transferring/discharging unstabilized patients based on inability to pay.
Question 2: Which federal law governs the conditions under which Medicare and Medicaid funds can be used to pay for abortion services?
- Affordable Care Act
- Hyde Amendment (Correct answer)
- Balanced Budget Act
- Social Security Act Title XIX
Correct answer: Hyde Amendment
The Hyde Amendment, passed annually as a rider to appropriations bills, restricts federal Medicaid funding for abortions except in cases of rape, incest, or life endangerment.
Question 3: A hospital's credentialing committee denies privileges to a physician. Under which legal doctrine may the physician challenge this decision in court?
- Respondeat superior
- Corporate negligence
- Due process rights under peer review statutes (Correct answer)
- Charitable immunity
Correct answer: Due process rights under peer review statutes
Physicians denied hospital privileges may challenge the decision by arguing they were denied procedural due process as required by hospital bylaws and state peer review statutes.
Question 4: The Physician Self-Referral Law (Stark Law) primarily prohibits physicians from referring Medicare patients to entities in which they have a financial relationship unless:
- The physician is board-certified in the relevant specialty
- A specific statutory or regulatory exception applies (Correct answer)
- The patient provides written consent to the referral
- The entity is accredited by The Joint Commission
Correct answer: A specific statutory or regulatory exception applies
Stark Law bans self-referrals unless a specific exception applies, such as the in-office ancillary services exception or the personal services exception.
Question 5: Under HIPAA's Breach Notification Rule, covered entities must notify affected individuals of a breach within how many days of discovering it?
- 30 days
- 45 days
- 60 days (Correct answer)
- 90 days
Correct answer: 60 days
HIPAA requires covered entities to notify affected individuals without unreasonable delay and within 60 calendar days of discovering a breach of unsecured PHI.
Question 6: Which legal standard applies when evaluating whether a hospital's quality of care meets professional norms in a negligence lawsuit?
- The reasonable patient standard
- The reasonable physician standard in the same or similar community (Correct answer)
- The national best-practice guideline standard
- The hospital's own internal policy standard
Correct answer: The reasonable physician standard in the same or similar community
Medical negligence is evaluated against what a reasonably competent practitioner in the same or similar community would do under like circumstances.
Question 7: A state passes a law requiring all health insurers to cover infertility treatments. This is an example of:
- Federal mandate under the ACA's essential health benefits
- State insurance mandate that may conflict with ERISA preemption for self-funded plans (Correct answer)
- Medicaid expansion requirement
- A CMS coverage determination
Correct answer: State insurance mandate that may conflict with ERISA preemption for self-funded plans
State insurance mandates apply to fully-insured plans but are preempted by ERISA for self-funded employer health plans, limiting their reach.
MHA Health Law and Regulations 2
Under the Emergency Medical Treatment and Labor Act (EMTALA), which action constitutes an illegal 'patient dumping'?