MPJE Patient Counseling and Confidentiality 3 — Questions and Answers
Question 1: A patient requests that the pharmacy NOT send their prescription refill reminders to their home address because their spouse does not know about their medication. Under HIPAA, the pharmacy must:
- Deny the request since it complicates pharmacy operations
- Accommodate the reasonable request to use an alternative means of communication (Correct answer)
- Require a written explanation from the patient before accommodating
- Notify the prescriber of the patient's unusual request
Correct answer: Accommodate the reasonable request to use an alternative means of communication
HIPAA requires covered entities to accommodate reasonable requests by individuals to receive communications of PHI by alternative means or at alternative locations.
Question 2: Which federal act requires pharmacies to maintain written policies and procedures for the pharmacist-in-charge to follow regarding patient counseling?
- OBRA '90 (Correct answer)
- HIPAA Privacy Rule
- The Controlled Substances Act
- The Food, Drug, and Cosmetic Act
Correct answer: OBRA '90
OBRA '90 required state Medicaid programs to mandate written policies and procedures for patient counseling at pharmacies.
Question 3: A pharmacy technician provides medication information to a patient waiting for a prescription. This practice is:
- Acceptable if the technician has completed a certified training program
- Generally considered practicing pharmacy without a license (Correct answer)
- Acceptable for general health information but not medication-specific information
- Permitted if a pharmacist is available to answer follow-up questions
Correct answer: Generally considered practicing pharmacy without a license
Providing patient-specific medication counseling is within the scope of pharmacy practice and generally cannot be delegated to pharmacy technicians.
Question 4: A patient's legal guardian requests full access to a minor patient's pharmacy records. The pharmacist should:
- Refuse access to protect the minor's privacy interests
- Provide full access since the guardian has authority over the minor
- Consult state law, as minors may have privacy rights for certain confidential services (Correct answer)
- Require both the minor's and guardian's signatures before releasing records
Correct answer: Consult state law, as minors may have privacy rights for certain confidential services
Many states grant minors privacy rights for certain treatments such as STI treatment, mental health, and substance abuse, requiring pharmacists to check state law.
Question 5: A pharmacist is approached by a police officer asking whether a specific individual has filled a prescription for a controlled substance. Without a warrant or proper legal process, the pharmacist should:
- Provide the information since law enforcement has authority to request it
- Decline to provide the information, citing patient confidentiality (Correct answer)
- Provide general information but not specific prescription details
- Refer the officer to the pharmacy's corporate compliance officer
Correct answer: Decline to provide the information, citing patient confidentiality
HIPAA generally does not permit disclosure of PHI to law enforcement without proper legal process such as a court order or subpoena.
Question 6: When a pharmacist counsels a patient on warfarin therapy, which topic is MOST critical to emphasize?
- The need to take the medication at the same time each day
- Foods, OTC drugs, and herbal supplements that can affect INR levels (Correct answer)
- The importance of storing the medication away from children
- The average cost of regular INR monitoring visits
Correct answer: Foods, OTC drugs, and herbal supplements that can affect INR levels
Warfarin has numerous interactions with foods, OTC drugs, and herbals that can significantly alter INR, making this counseling point critical for patient safety.
Question 7: A breach of unsecured PHI must be reported to affected individuals within how many days of discovery under HIPAA?
- 30 days
- 45 days
- 60 days (Correct answer)
- 90 days
Correct answer: 60 days
HIPAA's Breach Notification Rule requires covered entities to notify affected individuals of a breach without unreasonable delay and within 60 days of discovery.
MPJE Patient Counseling and Confidentiality 3
A patient requests that the pharmacy NOT send their prescription refill reminders to their home address because their spouse does not know about their medication.
Under HIPAA, the pharmacy must: