Persistent Depressive Disorder Regulatory Frameworks & Compliance 4 — Questions and Answers
Question 1: A licensed clinical social worker (LCSW) diagnosing and treating PDD must obtain licensure from which regulatory body?
- The federal Department of Health and Human Services (HHS)
- The state licensing board in the state where they practice (Correct answer)
- The American Association of Social Workers (AASW)
- The Joint Commission (TJC)
Correct answer: The state licensing board in the state where they practice
State licensing boards regulate and issue licenses for clinical social workers; requirements vary by state.
Question 2: Under the Affordable Care Act (ACA), mental health and substance use disorder services including PDD treatment are classified as which type of benefit that must be covered by qualified health plans?
- Supplemental benefits
- Essential health benefits (EHBs) (Correct answer)
- Preferred provider benefits
- Optional rider benefits
Correct answer: Essential health benefits (EHBs)
The ACA designates mental health and substance use disorder services as Essential Health Benefits (EHBs) that qualified health plans must cover.
Question 3: When a provider terminates the therapeutic relationship with a PDD patient, which compliance principle requires providing the patient with referrals and adequate time to seek alternative care?
- Duty to warn
- Proper clinical termination (avoiding abandonment) (Correct answer)
- Mandatory reporting obligation
- Informed assent
Correct answer: Proper clinical termination (avoiding abandonment)
Ethical and legal standards require proper clinical termination, including referrals and reasonable notice, to avoid patient abandonment.
Question 4: Which documentation element is most critical for supporting a PDD billing claim under CPT code 90837 (60-minute psychotherapy)?
- The therapist's educational credentials only
- Start and end times of the session with clinical content notes (Correct answer)
- The patient's insurance card number in the note
- A supervisor's co-signature in all outpatient settings
Correct answer: Start and end times of the session with clinical content notes
Time-based CPT codes like 90837 require documentation of session start and end times, along with clinical content, to support accurate billing.
Question 5: A PDD patient discloses in session that they have a specific, credible plan to harm an identified third party. The clinician's legal obligation to warn or protect that third party is known as which duty?
- Duty to report
- Tarasoff duty (duty to warn/protect) (Correct answer)
- Duty to hospitalize
- Duty to maintain confidentiality
Correct answer: Tarasoff duty (duty to warn/protect)
Following the Tarasoff v. Regents of the University of California ruling, clinicians have a duty to warn or protect identifiable third parties from credible patient threats.
Question 6: Which federal program provides mental health coverage for eligible low-income individuals with PDD and is jointly administered by the federal government and states?
- Medicare Part B
- Medicaid (Correct answer)
- TRICARE
- CHIP only
Correct answer: Medicaid
Medicaid is the joint federal-state program providing health coverage, including mental health services, to eligible low-income individuals.
Question 7: Facilities treating PDD and seeking Joint Commission accreditation must comply with which type of standards?
- Only CMS Conditions of Participation
- TJC's behavioral health care and human services standards (Correct answer)
- State Board of Pharmacy regulations
- FDA Good Clinical Practice guidelines
Correct answer: TJC's behavioral health care and human services standards
The Joint Commission's Behavioral Health Care and Human Services standards govern accredited mental health facilities, covering patient rights, treatment planning, and safety.
Persistent Depressive Disorder Regulatory Frameworks & Compliance 4
A licensed clinical social worker (LCSW) diagnosing and treating PDD must obtain licensure from which regulatory body?