Healthcare Compliance and Regulations Flashcards
7 cards from real RHIT practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Healthcare Compliance and Regulations flashcards as text
A covered entity discloses PHI to a vendor that manages its medical transcription services. Which document must govern this relationship under HIPAA?
Answer: Business Associate Agreement (BAA)
A Business Associate Agreement is required when a covered entity shares PHI with a vendor performing functions on its behalf.
Under the Medicare Conditions of Participation for medical records, which timeframe is required for completion of a medical record after patient discharge?
Answer: 30 days
CMS Conditions of Participation at 42 CFR §482.24 require that medical records be completed within 30 days following patient discharge.
Which of the following activities would constitute Medicare fraud, as opposed to Medicare abuse?
Answer: Intentionally billing for services never rendered
Fraud involves intentional deception; knowingly billing for services never rendered is a clear fraudulent act under the False Claims Act.
Which of the following best describes the purpose of the National Provider Identifier (NPI)?
Answer: It is a unique 10-digit identification number assigned to covered healthcare providers for HIPAA administrative transactions
The NPI is a unique 10-digit identifier required by HIPAA for covered healthcare providers in standard electronic administrative transactions.
The Anti-Kickback Statute (AKS) prohibits offering, paying, soliciting, or receiving remuneration to induce referrals for items or services covered by federal healthcare programs. Which category provides legal protection for certain business arrangements?
Answer: Safe harbors
OIG safe harbors describe specific arrangements that, if structured correctly, are protected from AKS prosecution.
A patient requests access to their electronic health record. Under the HIPAA Right of Access rule, the covered entity must provide access within how many days?
Answer: 30 days, with one 30-day extension possible
Under 45 CFR §164.524, covered entities must act on a request for access within 30 days and may extend by 30 days with written notice.
In ICD-10-CM, sequencing the principal diagnosis for inpatient records follows the UHDDS definition, which defines principal diagnosis as:
Answer: The condition established after study to be chiefly responsible for occasioning the admission
UHDDS defines principal diagnosis as the condition established after study to be chiefly responsible for causing the inpatient admission.