Persistent Depressive Disorder Regulatory Frameworks & Compliance 5 — Questions and Answers
Question 1: Under HIPAA's Minimum Necessary Rule, when sharing a PDD patient's records in response to a non-treatment request, a covered entity should disclose:
- The entire medical record to avoid any errors
- Only the information reasonably necessary to fulfill the specific request (Correct answer)
- Records from the past 10 years as a standard practice
- All records if the requester holds a professional license
Correct answer: Only the information reasonably necessary to fulfill the specific request
The Minimum Necessary Rule requires limiting disclosures to the least amount of PHI needed to accomplish the intended purpose.
Question 2: An employer learns that an employee has PDD through an occupational health evaluation. Under the ADA, the employer is required to:
- Share the diagnosis with the employee's supervisor immediately
- Maintain the medical information in a separate, confidential file (Correct answer)
- Include the diagnosis in the employee's general HR file
- Report the condition to the state health department
Correct answer: Maintain the medical information in a separate, confidential file
The ADA requires that employee medical information be kept in separate, confidential files apart from general personnel records.
Question 3: A telehealth provider delivering PDD treatment across state lines must primarily comply with licensing requirements in:
- The state where the provider's office is located
- The state where the patient is physically located during the session (Correct answer)
- The state with the most lenient telehealth regulations
- Federal telehealth law supersedes all state requirements
Correct answer: The state where the patient is physically located during the session
Most states require providers to hold a license in the state where the patient is physically located when receiving telehealth services.
Question 4: Which SAMHSA initiative provides block grant funding to states to support community mental health services, including treatment for PDD?
- Community Mental Health Centers Act
- Community Mental Health Services Block Grant (MHBG) (Correct answer)
- State Opioid Response (SOR) grant
- Mental Health Parity Enforcement Fund
Correct answer: Community Mental Health Services Block Grant (MHBG)
SAMHSA's Community Mental Health Services Block Grant (MHBG) funds states to support mental health services including treatment for adults with serious mental illness.
Question 5: In clinical documentation for PDD, the 'specifier' indicating that the patient has never had a major depressive episode during the course of PDD is recorded as:
- With pure dysthymic syndrome (Correct answer)
- With anxious distress
- With atypical features
- With melancholic features
Correct answer: With pure dysthymic syndrome
DSM-5 uses the specifier 'with pure dysthymic syndrome' when full major depressive episode criteria have never been met during PDD.
Question 6: When a managed care organization (MCO) requires prior authorization before approving ongoing PDD treatment, this practice is regulated under MHPAEA to ensure the process is comparable to prior authorization requirements for:
- Cosmetic procedures
- Medical and surgical benefits (Correct answer)
- Emergency room visits only
- Dental procedures
Correct answer: Medical and surgical benefits
MHPAEA requires that prior authorization requirements for mental health services be no more restrictive than those applied to analogous medical and surgical benefits.
Question 7: A group practice treating PDD patients uses a billing service to submit insurance claims. Under HIPAA, the billing company is classified as a:
- Covered entity
- Business associate (Correct answer)
- Hybrid entity
- Qualified health plan
Correct answer: Business associate
A billing service that handles PHI on behalf of a covered entity is a business associate and must sign a Business Associate Agreement (BAA).
Persistent Depressive Disorder Regulatory Frameworks & Compliance 5
Under HIPAA's Minimum Necessary Rule, when sharing a PDD patient's records in response to a non-treatment request, a covered entity should disclose: