Persistent Depressive Disorder Regulatory Frameworks & Compliance 3 — Questions and Answers
Question 1: A school counselor suspects a student has PDD. Under FERPA, which party generally has the right to access the student's mental health records maintained solely by the school?
- The student's treating psychiatrist
- The parent or guardian (for minors) (Correct answer)
- Any school staff member
- The state health department
Correct answer: The parent or guardian (for minors)
FERPA grants parents (and eligible students over 18) the right to access education records, including school-maintained mental health records.
Question 2: When billing Medicaid for PDD treatment sessions, providers must adhere to which documentation standard to support medical necessity?
- SOAP note format is federally mandated
- Documentation must support that the service meets the payer's medical necessity criteria (Correct answer)
- Only a DSM diagnosis code is required for reimbursement
- A minimum of 50 minutes per session must be documented
Correct answer: Documentation must support that the service meets the payer's medical necessity criteria
Medicaid requires that clinical documentation demonstrate medical necessity using the payer's defined criteria in order for claims to be reimbursed.
Question 3: Which federal agency oversees the approval of medications used to treat PDD, such as selective serotonin reuptake inhibitors (SSRIs)?
- Centers for Medicare & Medicaid Services (CMS)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- Food and Drug Administration (FDA) (Correct answer)
- Drug Enforcement Administration (DEA)
Correct answer: Food and Drug Administration (FDA)
The FDA is responsible for evaluating and approving prescription medications, including SSRIs used in the treatment of PDD.
Question 4: A clinician prescribing a controlled substance (e.g., a stimulant for comorbid ADHD with PDD) must hold a valid registration from which federal agency?
- FDA
- CMS
- DEA (Correct answer)
- SAMHSA
Correct answer: DEA
The DEA requires prescribers of controlled substances to hold a valid DEA registration number.
Question 5: Under the DSM-5, a PDD diagnosis in an adult requires depressed mood for most of the day, more days than not, for a minimum of how long?
- 6 months
- 1 year
- 2 years (Correct answer)
- 3 years
Correct answer: 2 years
DSM-5 requires at least 2 years of chronic depressed mood (1 year in children/adolescents) for a PDD diagnosis.
Question 6: Which law specifically protects the confidentiality of substance use disorder treatment records and may affect patients with PDD who also have co-occurring substance use disorder?
- HIPAA Privacy Rule
- 42 CFR Part 2 (Correct answer)
- MHPAEA
- ADA Title II
Correct answer: 42 CFR Part 2
42 CFR Part 2 provides heightened confidentiality protections for records from federally assisted substance use disorder treatment programs.
Question 7: In a mental health outpatient setting, informed consent for PDD treatment typically must include which of the following elements?
- The provider's malpractice insurance limits
- The nature of the treatment, risks, benefits, and alternatives (Correct answer)
- A complete list of all other patients treated by the provider
- The provider's personal opinions about the diagnosis
Correct answer: The nature of the treatment, risks, benefits, and alternatives
Informed consent requires disclosing the nature of treatment, its risks and benefits, and available alternatives so the patient can make an autonomous decision.
Persistent Depressive Disorder Regulatory Frameworks & Compliance 3
A school counselor suspects a student has PDD.
Under FERPA, which party generally has the right to access the student's mental health records maintained solely by the school?