Regulatory and Compliance Standards Flashcards

The 21st Century Cures Act's information blocking rule primarily aims to:

Answer: Prevent healthcare organizations from blocking patient access to their electronic health information

The 21st Century Cures Act's information blocking rule prohibits practices that interfere with access, exchange, or use of electronic health information by patients and their authorized representatives.

Under the Americans with Disabilities Act (ADA), hospitals must provide effective communication to patients with disabilities. This may include:

Answer: Providing qualified sign language interpreters or other auxiliary aids at no cost to the patient

The ADA requires healthcare facilities to provide effective communication aids and services, such as qualified interpreters, at no cost to individuals with disabilities.

A patient who was recently treated is now in collections. Under the Fair Debt Collection Practices Act (FDCPA), a third-party collector may NOT:

Answer: Contact the patient at work if the employer prohibits such calls

The FDCPA prohibits debt collectors from contacting a consumer at their place of employment if the collector knows the employer prohibits such communications.

A patient's 'right to request restrictions' under HIPAA means the patient can:

Answer: Ask the provider to limit uses or disclosures of PHI, which the provider generally is not required to agree to

HIPAA grants patients the right to request restrictions on PHI use or disclosure, but covered entities are not required to agree — except for restrictions on disclosures to health plans for self-paid services.

Which federal program provides health coverage for low-income individuals and families and is jointly funded by federal and state governments?

Answer: Medicaid

Medicaid is a joint federal and state program that provides health coverage to eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities.

The Conditions of Participation require hospitals to have a formal patient grievance process. A grievance differs from a complaint in that a grievance is:

Answer: A written or formal complaint that requires investigation and a written response

Under CoPs, a grievance is a formal written complaint or a verbal complaint not resolved at the time of service, requiring a formal investigation and written response from the hospital.

Under HIPAA, a covered entity that experiences a breach of unsecured PHI affecting 500 or more individuals in a state must notify:

Answer: Affected individuals, HHS, and prominent local media outlets within 60 days

For breaches affecting 500 or more residents of a state or jurisdiction, covered entities must notify affected individuals, HHS, and prominent local media outlets without unreasonable delay and within 60 days of discovery.