PBC Regulatory Compliance & Legal Framework 3 — Questions and Answers
Question 1: Which U.S. federal law governs workplace accommodations that may be required for employees experiencing pregnancy loss, including miscarriage or stillbirth?
- Family and Medical Leave Act (FMLA) only
- Pregnancy Discrimination Act (PDA) only
- FMLA and potentially the ADA for complications arising from pregnancy loss (Correct answer)
- The Pregnant Workers Fairness Act (PWFA) only
Correct answer: FMLA and potentially the ADA for complications arising from pregnancy loss
Both FMLA (for qualifying employers) and ADA (if physical or mental health complications arise) may apply to employees experiencing pregnancy loss.
Question 2: Under the Emergency Medical Treatment and Labor Act (EMTALA), what obligation does a hospital emergency department have when a patient presents with an active miscarriage?
- Refer the patient to an OB/GYN office immediately
- Provide a medical screening examination and stabilizing treatment regardless of ability to pay (Correct answer)
- Treat only if the patient has prior authorization from her insurer
- Transfer the patient to a specialty center before any treatment
Correct answer: Provide a medical screening examination and stabilizing treatment regardless of ability to pay
EMTALA requires that any patient presenting to an emergency department receive a medical screening exam and stabilizing treatment regardless of insurance status.
Question 3: A bereaved parent requests their stillborn infant's footprints and photographs from the hospital. Under typical state laws and regulations, what should the hospital do?
- Decline, as hospitals are not required to collect or retain such mementos
- Provide them, as many states require or encourage hospitals to collect keepsakes for bereaved families (Correct answer)
- Only provide them if the parent signed a consent form before delivery
- Charge a fee for the mementos since they are not standard medical care
Correct answer: Provide them, as many states require or encourage hospitals to collect keepsakes for bereaved families
Many states have enacted laws requiring hospitals to offer keepsakes such as footprints and photographs to parents experiencing stillbirth or neonatal death.
Question 4: Which privacy principle must be upheld when a perinatal bereavement coordinator discusses a case during a multi-disciplinary team meeting?
- Only the patient's name may be shared; all other details must be withheld
- The minimum necessary standard — sharing only the PHI needed for the purpose of the discussion (Correct answer)
- Full records must be shared with all team members to ensure coordinated care
- No PHI may ever be shared in group settings under any circumstances
Correct answer: The minimum necessary standard — sharing only the PHI needed for the purpose of the discussion
HIPAA's minimum necessary standard requires that only the PHI required for a specific purpose is disclosed, even within treatment team meetings.
Question 5: When a perinatal loss involves a potential medical error, what ethical and legal obligation does the healthcare team have toward the family?
- Avoid disclosing the error to prevent litigation
- Disclose the error honestly in keeping with transparency and many states' disclosure laws (Correct answer)
- Only disclose if the family specifically asks whether an error occurred
- Disclose only after the hospital's legal team has reviewed the case for liability
Correct answer: Disclose the error honestly in keeping with transparency and many states' disclosure laws
Many states have disclosure laws and accreditation standards require transparent communication with patients and families when unanticipated outcomes occur.
Question 6: The Genetic Information Nondiscrimination Act (GINA) protects individuals from discrimination based on genetic information. How might GINA apply in perinatal bereavement care?
- GINA has no relevance to perinatal care settings
- GINA protects families from insurance and employment discrimination based on genetic causes of pregnancy loss (Correct answer)
- GINA applies only to the deceased infant, not the surviving parents
- GINA only applies when genetic testing is ordered by a specialist, not an OB
Correct answer: GINA protects families from insurance and employment discrimination based on genetic causes of pregnancy loss
GINA prohibits insurers and employers from using genetic information, including results from testing after pregnancy loss, to discriminate against surviving family members.
Question 7: A hospital social worker learns that a bereaved mother is undocumented and fears her immigration status may be affected by interacting with hospital staff. What legal framework guides the social worker's response?
- Report the patient's status to immigration authorities as required by federal law
- Provide care without discrimination; EMTALA and HIPAA apply regardless of immigration status (Correct answer)
- Delay care until immigration status is verified to protect the hospital from liability
- Refer the patient to a federally qualified health center instead
Correct answer: Provide care without discrimination; EMTALA and HIPAA apply regardless of immigration status
EMTALA requires emergency care regardless of immigration status, and HIPAA protects PHI including information about immigration status from unauthorized disclosure.
PBC Regulatory Compliance & Legal Framework 3
Which U.S. federal law governs workplace accommodations that may be required for employees experiencing pregnancy loss, including miscarriage or stillbirth?