NP Regulatory Frameworks & Compliance 2 — Questions and Answers
Question 1: Under the Drug Enforcement Administration (DEA) schedule system, which schedule indicates drugs with accepted medical use but the highest potential for abuse?
- Schedule I
- Schedule II (Correct answer)
- Schedule III
- Schedule IV
Correct answer: Schedule II
Schedule II drugs have accepted medical use but the highest potential for abuse among drugs with accepted medical use, requiring triplicate prescriptions in many states.
Question 2: A nurse practitioner's prescriptive authority is PRIMARILY governed by which entity?
- The Drug Enforcement Administration (DEA)
- The state board of nursing or medicine (Correct answer)
- The American Association of Nurse Practitioners (AANP)
- The Joint Commission
Correct answer: The state board of nursing or medicine
Prescriptive authority for NPs is determined by state law and regulated by the state board of nursing or, in some states, jointly with the state board of medicine.
Question 3: Which federal law prohibits healthcare providers from making referrals for designated health services to entities with which they have a financial relationship?
- Anti-Kickback Statute
- Stark Law (Physician Self-Referral Law) (Correct answer)
- False Claims Act
- HIPAA Privacy Rule
Correct answer: Stark Law (Physician Self-Referral Law)
The Stark Law prohibits physician (and by extension, NP) self-referrals to entities in which they have a financial interest for designated health services billed to Medicare or Medicaid.
Question 4: An NP writes a prescription for a controlled substance but post-dates it by two weeks. This practice is:
- Permitted if the patient is a known, established patient
- Permitted for Schedule III-V substances only
- Prohibited under federal DEA regulations (Correct answer)
- Permitted with prior authorization from the pharmacy
Correct answer: Prohibited under federal DEA regulations
Federal DEA regulations prohibit post-dating controlled substance prescriptions; prescriptions may only be filled on or after the date they are issued.
Question 5: The concept of 'full practice authority' for NPs means the state law allows NPs to:
- Practice only in federally qualified health centers
- Evaluate, diagnose, order tests, and prescribe without physician oversight (Correct answer)
- Prescribe Schedule II substances independently
- Bill Medicare independently without a supervising physician
Correct answer: Evaluate, diagnose, order tests, and prescribe without physician oversight
Full practice authority states allow NPs to practice to the full extent of their education and training without required physician collaboration or supervision agreements.
Question 6: Under HIPAA, which of the following is NOT considered Protected Health Information (PHI)?
- A patient's diagnosis documented in the medical record
- A patient's name combined with their date of birth
- De-identified statistical health data with no patient identifiers (Correct answer)
- Billing records that include the patient's insurance ID number
Correct answer: De-identified statistical health data with no patient identifiers
De-identified health information that has been stripped of all 18 HIPAA identifiers is not considered PHI and is not subject to HIPAA protections.
Question 7: A nurse practitioner discovers a colleague has been falsifying patient records to support fraudulent Medicare billing. The NP's FIRST obligation is to:
- Confront the colleague directly before taking any other action
- Report the conduct through appropriate internal channels or to the OIG (Correct answer)
- Wait to see if the billing department catches the error
- Notify the patient whose records were falsified
Correct answer: Report the conduct through appropriate internal channels or to the OIG
Fraudulent Medicare billing is a federal offense under the False Claims Act; the NP must report through internal compliance channels or directly to the Office of Inspector General (OIG).
NP Regulatory Frameworks & Compliance 2
Under the Drug Enforcement Administration (DEA) schedule system, which schedule indicates drugs with accepted medical use but the highest potential for abuse?