RHIT Healthcare Compliance and Regulations 5

Question 1

A facility discovers that an employee accessed the electronic health records of a celebrity patient out of curiosity, without a treatment relationship. Under HIPAA, this is classified as:

Accepted Answer

An impermissible use resulting in a presumed breach, unless a low probability of compromise analysis clears it

Answer

An authorized incidental disclosure

Answer

An excepted treatment disclosure

Answer

A permissible workforce training activity

Question 2

The Genetic Information Nondiscrimination Act (GINA) Title II prohibits employers from using genetic information in employment decisions. In the context of HIPAA, genetic information is classified as:

Accepted Answer

A type of PHI that is generally prohibited from use for underwriting purposes by health plans

Answer

Excluded from PHI protections

Answer

Freely disclosable with patient authorization

Answer

Protected only if it relates to a current diagnosis

Question 3

A release of information specialist receives a request for records from a patient's attorney. Which document is essential before releasing records in a non-litigation context?

Accepted Answer

A valid written HIPAA-compliant authorization signed by the patient

Answer

A court order

Answer

A subpoena signed by the attorney

Answer

Verbal confirmation from the treating physician

Question 4

Which type of Medicare audit uses sophisticated data analysis to identify providers with unusual billing patterns before conducting a review?

Accepted Answer

Zone Program Integrity Contractor (ZPIC) data analysis

Answer

Comprehensive Error Rate Testing (CERT)

Answer

Recovery Audit Contractor (RAC) automated review

Answer

Targeted Probe and Educate (TPE)

Question 5

A state law grants patients broader access rights to their mental health records than HIPAA provides. Under the principle of federal preemption, which standard applies?

Accepted Answer

The state law applies because it provides greater patient protections

Answer

HIPAA always preempts state law

Answer

The federal standard applies only for Medicare patients

Answer

Neither law applies; the provider uses professional judgment

Question 6

Under the Health Care Quality Improvement Act (HCQIA), the National Practitioner Data Bank (NPDB) must be queried by hospitals when:

Accepted Answer

Any physician applies for medical staff privileges and at least every two years thereafter

Answer

Only when a physician is suspected of malpractice

Answer

Only at initial credentialing, not at re-credentialing

Answer

When a physician is reported to the state medical board

Question 7

Which of the following BEST describes the purpose of a Corporate Integrity Agreement (CIA) negotiated between a healthcare provider and the OIG?

Accepted Answer

It establishes compliance obligations a provider must fulfill as part of a settlement to avoid exclusion from federal programs

Answer

It grants immunity from future False Claims Act prosecutions

Answer

It replaces the provider's internal compliance program entirely

Answer

It is a voluntary self-disclosure mechanism with no enforcement consequences