MTM Regulatory Compliance & Ethical Standards 5

Question 1

A pharmacist's MTM employer instructs staff to bill for Targeted Medication Reviews (TMRs) that were never performed. Which whistleblower protection law is MOST relevant to a pharmacist who reports this internally and then externally?

Accepted Answer

False Claims Act qui tam provisions

Answer

The False Claims Act's qui tam provisions allow and protect whistleblowers who report fraud against federal health programs, entitling them to a portion of recovered funds.

Question 2

Which principle of beneficence-based ethics BEST describes the obligation to actively prevent harm to a patient during MTM, rather than just avoiding it?

Accepted Answer

Positive beneficence

Answer

Positive beneficence requires active efforts to benefit patients and prevent harm, going beyond the more passive non-maleficence standard of merely avoiding harm.

Question 3

A patient enrolled in MTM is also enrolled in a clinical trial. How should the MTM pharmacist handle medications the patient receives as a trial participant?

Accepted Answer

Document trial medications, assess interactions with regular medications, and coordinate with the trial team

Answer

MTM pharmacists should document and assess all medications including investigational drugs for interactions, coordinating with the clinical trial team to ensure patient safety.

Question 4

The CMS Star Ratings program evaluates Part D plan quality, including MTM metrics. Which pharmacist behavior MOST directly contributes to improving a plan's Star Rating related to MTM?

Accepted Answer

Ensuring high-quality CMR completion rates with documented follow-up and patient engagement

Answer

Star Ratings reward high CMR completion rates with genuine patient engagement and documented outcomes, not just procedural completion for metric timing.

Question 5

In an MTM setting, a pharmacist realizes a patient lacks decision-making capacity. Who is the appropriate surrogate decision-maker in the absence of a designated healthcare proxy?

Accepted Answer

The next of kin in accordance with state law hierarchy (typically spouse, then adult children)

Answer

When no healthcare proxy is designated, state laws typically establish a hierarchy of surrogate decision-makers, usually beginning with the spouse or closest adult relative.

(MTM) Medication Therapy Management Board Certification Practice Test

(MTM) Medication Therapy Management Board Certification Practice Test

MTM Regulatory Compliance & Ethical Standards 5