(Law) Flashcards

A PT documents that a patient 'tolerated treatment well' when in fact the patient reported significant pain during the session. This documentation is best described as:

Answer: Fraudulent or misleading documentation that misrepresents the clinical encounter

Documenting outcomes that contradict the patient's actual reported experience constitutes misleading documentation, which can constitute fraud and exposes the PT to liability.

Which law requires that emergency medical treatment be provided regardless of a patient's ability to pay or insurance status, relevant to PTs working in emergency settings?

Answer: EMTALA (Emergency Medical Treatment and Labor Act)

EMTALA requires Medicare-participating hospitals to provide emergency medical screening and stabilization regardless of a patient's ability to pay.

A PT's malpractice insurance policy provides 'claims-made' coverage. The PT retires and cancels the policy. A patient then files a claim for an injury that occurred during active coverage. The PT:

Answer: May not be covered unless tail coverage (extended reporting period) was purchased

Claims-made policies only cover claims filed while the policy is active; tail coverage must be purchased to cover claims filed after policy cancellation for events during active coverage.

Under the Anti-Kickback Statute, a PT who accepts payment from a medical equipment company for referring patients to purchase their products may face:

Answer: Criminal penalties including fines and imprisonment, plus exclusion from federal healthcare programs

The Anti-Kickback Statute is a criminal law; violations can result in felony charges, substantial fines, imprisonment, and exclusion from Medicare/Medicaid.

A PT notices a colleague routinely leaving a confused elderly patient unattended on a treatment table, resulting in repeated near-falls. The PT's legal and ethical obligation is to:

Answer: Report the concern through appropriate channels (supervisor, risk management, or state board) to protect patient safety

PTs have both an ethical and legal duty to report unsafe practices that put patients at risk; failure to act can result in liability for known harm that was not addressed.

A PT is asked to sign a productivity report that understates actual visit times to inflate per-unit billing rates. Signing would make the PT:

Answer: A participant in healthcare fraud, regardless of who submitted the billing

Knowingly signing false productivity or billing records makes the PT a participant in healthcare fraud under the False Claims Act, regardless of who submits the final claim.

Which of the following best describes the legal concept of 'informed consent' as it applies to physical therapy?

Answer: A process in which the PT discloses the nature of treatment, material risks, benefits, alternatives, and consequences of refusal so the patient can make a voluntary decision

Informed consent is an ongoing communication process — not merely a signature — requiring disclosure of treatment details, risks, benefits, and alternatives so the patient can make an autonomous decision.