MPT (Law) 3 — Questions and Answers
Question 1: Which of the following best describes 'abandonment' in the context of physical therapy practice?
- Declining to treat a new patient without justification
- Unilaterally terminating the therapeutic relationship without adequate notice or referral while the patient still needs care (Correct answer)
- Referring a patient to another specialist mid-treatment
- Discharging a patient after goals are met
Correct answer: Unilaterally terminating the therapeutic relationship without adequate notice or referral while the patient still needs care
Abandonment occurs when a PT unilaterally ends treatment without proper notice, transition planning, or referral when ongoing care is still medically necessary.
Question 2: Under Medicare Part B, physical therapy services are covered only when they are:
- Prescribed by a chiropractor
- Medically necessary, skilled, and provided or supervised by a licensed PT (Correct answer)
- Provided in an inpatient hospital setting only
- Authorized by a state Medicaid office
Correct answer: Medically necessary, skilled, and provided or supervised by a licensed PT
Medicare Part B covers outpatient PT services that are medically necessary and require the skills of a licensed physical therapist.
Question 3: A PT bills Medicare for 60-minute sessions but consistently provides 45-minute sessions. This practice constitutes:
- Upcoding, a form of healthcare fraud (Correct answer)
- Acceptable billing if outcomes are achieved
- A documentation error only, not fraud
- Appropriate billing under incident-to rules
Correct answer: Upcoding, a form of healthcare fraud
Billing for more time or services than actually provided is upcoding, which constitutes healthcare fraud under the False Claims Act.
Question 4: The False Claims Act allows private citizens to file suit on behalf of the government against entities committing fraud. This provision is known as:
- Qui tam (Correct answer)
- Res judicata
- Pro bono
- In loco parentis
Correct answer: Qui tam
The qui tam provision of the False Claims Act allows 'relators' (whistleblowers) to file fraud suits on the government's behalf and share in any recovery.
Question 5: Which standard is used to evaluate whether a PT's conduct met the expected level of professional care in a negligence lawsuit?
- The reasonable layperson standard
- The standard of care — what a reasonably competent PT would do under similar circumstances (Correct answer)
- The best possible outcome standard
- The treating physician's judgment
Correct answer: The standard of care — what a reasonably competent PT would do under similar circumstances
The standard of care in negligence cases is measured against what a reasonably competent PT with similar training would have done in the same situation.
Question 6: A PT documents a fall that injured a patient during therapy but does not alter the medical record. Later, the PT adds a note attempting to minimize the incident. This subsequent alteration could be considered:
- Appropriate addendum documentation
- Fraudulent alteration of medical records, which can be used as evidence of liability (Correct answer)
- A minor administrative correction
- Standard incident reporting procedure
Correct answer: Fraudulent alteration of medical records, which can be used as evidence of liability
Altering medical records after an adverse event to minimize apparent liability constitutes fraud and can result in criminal charges and licensure revocation.
Question 7: Which federal act prohibits healthcare providers from referring patients to entities with which they have a financial relationship, unless a specific exception applies?
- Anti-Kickback Statute
- Stark Law (Physician Self-Referral Law) (Correct answer)
- EMTALA
- HIPAA Privacy Rule
Correct answer: Stark Law (Physician Self-Referral Law)
The Stark Law prohibits physician self-referrals for designated health services (including PT) to entities in which the physician has a financial interest, absent an exception.
MPT (Law) 3
Which of the following best describes 'abandonment' in the context of physical therapy practice?