Term
| Medicare's Conditions of Participation for hospitals require patient health records be retained for at least _______ years unless a longer period is required by state or local laws. |
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Definition
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Term
| Kyle, the HIM director, has received a request from a pt to modify/correct the pt's health record. The appropriate action for him to take is: |
|
Definition
| Route the request to the physician who wrote the note in question. |
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Term
| Unless state or federal laws require longer time periods, AHIMA recommends patient health information for minors be retained for at least how long? |
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Definition
| Age of majority plus statute of limitations. |
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Term
| A pharmacist misreads a prescription and fills it with the wrong drug. The cashier accepts payment for the drug and the consumer leaves. The consumer, who had been filling the same prescription for the past two years, consumes the drug and suffers injuries. Who is responsible for the consumer's injuries? |
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Definition
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Term
| A major consideration in a hospital/facility closure is to |
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Definition
| Assure that authorized parties have access to the information as provided by law. |
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Term
| The Patient Self-Determination Act of 1990 requires the health record indicate if |
|
Definition
| The patient has an advance directive for heatlh care |
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Term
| A verbal consent is binding if it |
|
Definition
| Can be proven or corroborated |
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Term
| A court order need not be sought in those cases in which refusal of treatment poses a serious threat to the patient's ehalth, especially in the case of minors. true/false |
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Definition
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Term
Which of the following situations would not allow a minor to consent to treatment and refuse disclosure of information?
* a minor seeking treatment for a suicide attempt
* A minor seeking treatment for sexually transmitted disease
* A minor seeking treatment for ETOH and substance abuse
* An emancipated minor seeking treatment for breast enlargement |
|
Definition
| A minor seeking treatment for a suicide attempt |
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Term
All of the following should be part of informed consent for a procedure EXCEPT:
*Reasonable forseeable risks of performing the procedure
* Complications or side effects
* Anticipated results if the procedure is not performed
* Cost of the procedure |
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Definition
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Term
| If there is no one available to consent to non-emergency treatment for an incompetent patient, the hospital should |
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Definition
| Obtain a court order for treatment or seek next of kin |
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Term
| The patient, age 17, is to have a craniotomy. he is the son of divorced parents, has been adopted by his grandmother, and is married. Who should sign the operative consent? |
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Definition
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Term
| Who is legally responsible for obtaining the patient's consent for surgery? |
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Definition
| Surgeon performing the surgery |
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Term
| Photographs, videotapes, and other images should be clearly identified with |
|
Definition
| Patient's name, date, and identification number |
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Term
When representatives from the news, media or law enforcement agencies ask to photograph a patient, permission may be given if which of the conditions have been met
* the patient's physician does not feel it would be detrimental to the pt
* the patient or his/her legal representative signs a written authorization agreeing to the photography
* no state laws to the contrary exist
* all of the above |
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Definition
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Term
| What law(s) allows for patients to amend information? |
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Definition
| Both HIPAA and the Privacy Act of 1974 |
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Term
| Internal use of patient information for patient care purposes should be granted |
|
Definition
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Term
| A gentleman walks into the HIM department asking to have his history of smoking removed from his H&P. He claims this information is erroneous and has created a problem with his work-related accident claim. He insists this be corrected immediately. The patient has already contacted the attending physician who refused to do anything about the situation. There is no visit history after the admission in question. You should: |
|
Definition
| Include as part of the record any correspondence the patient may write explaining he disagrees with the smoking history. This will be flagged to be included as part of the history whenever the record is subsequently released; however, there is no guarantee this inclusion will affect the current situation |
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Term
| James is writing the notice of privacy practices required by HIPAA. He writes the hospital will use PHI to report infectious diseases to public health officials. Why can he write this? |
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Definition
| it is an example of how PHI will be used for healthcare operations |
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Term
Which of the following is not a time when you can share what you know?
* A nurse speaking with the physician in the patient's room
* Staff members discussing patient's in the elevator.
*The admission clerk verifying over thephone the patient is in the house
* The hospital operator paging code blue in room 3 north |
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Definition
| Staff members discussing patients in the elevator |
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Term
Today is January 30, 2010. Barbara has received a written authorization from an attorney for the health records on John Marshall. The dates of service requested by the authorization are the admission of January 2,2010 through January 8, 2010. The authorization is dated January 3, 2010. Which of the followin is the appropriate response?
* Release the health records as requested
* Return the authorization and request one dated on or after January 8, 2010
* Ask the supervisor to process the request
* None of the above |
|
Definition
| Release the health record as requested |
|
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Term
| Telephone requests for release of information are best accepted only if: |
|
Definition
| The patient is under urgent or emergency treatment |
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Term
Which of the following is not a component of an acceptable authorization for release of health information?
* Patient's date of birth
* Attending physician's signature
* Individual to receive the information
* The patient or legal representative signature |
|
Definition
| Attending physicians signature |
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Term
| An attorney, with proper authorization from a patient, obtains a copy of the patient's health record. The attorney then releases a copy of the record to a second attorney. This practice is called: |
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Definition
|
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Term
| Release of information in response to appropriate telephone requests should be made only after: |
|
Definition
| The caller's identity is verified |
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Term
| As a general rule, a person making a report in good faith and under statutory command, e.g. child abuse, communicable diseases, births, deaths, is |
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Definition
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Term
| Ron has asked for an accounting of disclosures of his health record. He seems surprised not to see his physician, Dr. Emory, on it. What do you tell him? |
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Definition
| Disclosures used for treatment are not recorded |
|
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Term
| Mandatory reporting requirements for vital statistics generally |
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Definition
| Do not require authorization by the patient |
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Term
| Brad Thomas is a former patient at St. John's Hospital. He came to the HIM department today and asked for a list of people who have requested his medical record over the past 10 years. He also wants to know what was released. Which isthe appropriate response to Brad's request? |
|
Definition
| Give him the information on records released since the HIPAA privacy rule was implemented, not to exceed six years |
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Term
| When a patient expires, who has the right to give authorization for release of information of the hospital health record? |
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Definition
| The executor of the patient's estate |
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Term
Sandra asks the Ashville General Hospital for a list of disclosed PHI. According to HIPAA, which of the following is included in the list she receives?
* Information released for preadmission approval by insurance company
* Lab receiving blood for testing
* Reporting gunshot wound to authorities
* Information releaed to the patient |
|
Definition
| Lab receiving blood for testing |
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Term
The IRB has approved Dr. Grant's research with the stipulation that only a limited data set is provided. Which of the following would be a violation of the requirement to remove identifiers?
* Street address
* Discharge disposition
* Admission year
* Diagnosis |
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Definition
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Term
What constitutes wrongful disclosure?
* Allowing use of email addresses for marketing health care products
* Attending physician obtaining lab report to monitor patient digoxin levels
* Allowing a consulting physician to view patient information
* Sending death information to state office of vital statistics |
|
Definition
| Allowing use of email addresses for marketing health care products |
|
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Term
| Due to the sensitive nature of the following information, it should not be transmitted by fax |
|
Definition
| None of the above should be transmitted by fax |
|
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Term
| HIPAA allows for the use of PHI in research without individual authorization if |
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Definition
|
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Term
The Confidentiality of Alcohol and Drug Abuse Patient Records rule includes all of the following EXCEPT:
* Identity of patient
* Diagnosis of patient
* Treatment of patient
* Payment of bill |
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Definition
|
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Term
| When releasing health information with a written patient authorization conforming to federal rules concerning confidentiality of ETOH and drug abuse treatment records you should |
|
Definition
| Release only information applicable to the purpose of disclosure and include a written statement warning against redisclosure |
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Term
| Written authorization from the pt is required for which of the following in order to learn a patient's HIV status. |
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Definition
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Term
If a patient has a primary Dx of alcoholism, which of the following information items may be released with his authorization?
* His admission and discharge dates only
* His name only
* His name, address, age, sex, and attending physician
* No information, including the fact he was treated at the facility. |
|
Definition
| No information, including the fact he was treated at the facility |
|
|
Term
Federal confidentiality rules, 42 CFR Part 2, prohibit redisclosure EXCEPT
* To medical personnel to address a genuine medical emergency
* If authorized by an appropriate court order
* Expressy permitted by the written consent of the person to whom it pertains
* All of the above |
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Definition
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Term
| Authorization is an agreement from the patient to use or disclose patient-specific information to carry out treatment, payment and health care operations. true/false |
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Definition
|
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Term
| Consent is permission for specific disclosures not otherwise authorized bylaw. true/false |
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Definition
|
|
Term
| Repositories of personal health records (PHRs) in electronic form operated by governmental or commercial entities who serve as trusted custodians of the data |
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Definition
|
|
Term
| Dictate that the patient be notified of the uses of their record and be given the opportunity to consent, reject, or request restrictions of this information for any or all of the many uses the health record serves |
|
Definition
| Notice of Information Practices |
|
|
Term
| De-identified data are repositories of personal health records (PHRs) in electronic form operated by governmental or commercial entities who serve as trusted custodians of the data |
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Definition
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Term
| A ________ is a written consent form that permits the dissemination of confidential health information to third parties |
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Definition
|
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Term
| A statement placing the recipient on notice that the information received may be used for the stated purpose and stating that the information should be destroyed after the stated purpose is fulfilled |
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Definition
|
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Term
| A collection of a patient's important health information that is actively maintained and updated in paper or electronic form. |
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Definition
|
|
Term
| A Release of Information is a written consent form that permits the dissemination of confidential health information to third parties |
|
Definition
|
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Term
| ________ dictate that the patient be notified of the uses of their record and be given opportunity to consent, reject, or request restrictions of this information for any or all of the many uses the health record serves. |
|
Definition
| Notice of Information Practices |
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Term
|
Definition
| Federal regulations restrict identification of a patient who is in a facility publicly identified as providing substance abuse treatment. Written consent of thepatient or a court order is required for disclosure. |
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Term
|
Definition
| Patients must be given notice of federal confidentiality requirements upon admission to a substance abuse treatment program or soon thereafter |
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Term
| Specialized Patient Record |
|
Definition
| Health records of patients undergoing treatment for certain illnesses, such as substance abuse or mental illness, or in non-acute care settings, such as the patient's home. These records are subject to different legal requirements from those in an acute care setting. |
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Term
|
Definition
| Entities whose sole purpose is to provide alcohol or drug abuse diagnosis and treatment. |
|
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Term
|
Definition
| A system that assigns a unique identifier to the individual tested, therby protecting his or her identity. |
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|
Term
| A record, separate from the official medical record, maintained by the clinician in the mental health or developmental disability context that gives the clinician's viewpoint of the patient and their communication. |
|
Definition
|
|
Term
| Entities whose sole purpose is to provide alcohol or drug abuse diagnosis and treatment is referred to as a treatment program |
|
Definition
|
|
Term
| Patient's must be given notice of federal confidentiality requirements upon admission to a substance abuse treatment program or soon thereafter |
|
Definition
|
|
Term
| Health records of patients undergoing treatment for certain illnesses, such as substance abuse, or mental illness, or non-acute care settings such as patients home is referred to as specialized patient record. |
|
Definition
|
|
Term
| Entities whose sole purpose is to provide alcohol or drug abuse diagnosis and treatment |
|
Definition
|
|
Term
| Health records of patients undergoing treatment for certain illnesses, such as substance abuse, or mental illness, or non acute care settings such as patient's home |
|
Definition
| Specialized patient record |
|
|
Term
| Health records of patient's undergoing treatment for certain illnesses, including substance abuse and mental illness, in non-acute care settings, are referred to as ________ patient records. |
|
Definition
|
|
Term
| Federal regulations restrict identification of a patient who is in a facility publicly identified as providing substance abuse treatment is called patient identification. |
|
Definition
|
|
Term
| Health information may be disclosed to third parties through a ______ with patient authorization. |
|
Definition
|
|
Term
| ________ is covered by state statutes that protect peer review deliberations and records from subpoenas, discovery, or introduction into evidence. |
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Definition
|
|
Term
| Discovery is pertinent and proper. true/false |
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Definition
|
|
Term
| An incident report is documentation of an adverse incident. true/false |
|
Definition
|
|
Term
|
Definition
| Pertinent and proper evidence. Rules of evidence determine if evidence is pertinent and proper. For example, in the context of medical records, the applicable rule of evidence is the hearsay rule. |
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Term
|
Definition
| A means for providing a party, in advance of trial, with access to facts that are within theknowledge of the other side, to enable the party to better try his or her case. Examples include depositions, written interrogatories, production of documents or things, physical and mental examinations, and requests for admission. |
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|
Term
|
Definition
| The oblication of the health-care provider to maintain patient information in a manner that will not permit dissemination beyond the health-care provider. The origin of confidentiality is found in the Hippocratic Oath. |
|
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Term
| Attorney-client privilege |
|
Definition
| The legal protection of communications between a client and his or her attorney, made in confidence for thepurpose of obtaining legal advice. |
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|
Term
|
Definition
| The documentation of an adverse incident, whether done on a paper form or through a computerized database with access controls. It describes the incident itself, inclouding the time, date, and place of occurrence, along with the condition of the subject of the incident, statements or observations of witnesses, and any responsive action taken. |
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|
Term
| _______ is timely and complete, meaning that all entries in the record are authored and autenticated and reflect the total care actually rendered to the patient. |
|
Definition
|
|
Term
| _________ refers to the function of analyzing and evaluating all of the risks that confront an organization, not just the legal, financial, and medical risks that are traditionally considered. |
|
Definition
| Enterprise risk management |
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|
Term
| State statutes that protect peer review deliberations and records form subpoenas, discovery, or introduction into evidence. |
|
Definition
|
|
Term
| An improvement technique that examines patterns of activity to define optimum performance and determine how to achieve that performance is called proper documentation. true/false |
|
Definition
|
|
Term
| An improvement technique that examines patters of activity to define optimum performance and determine how to achieve that performance is called: |
|
Definition
|
|
Term
| Risk management refers to the function of analyzing and evaluating all of the risks that confront an organization, not just the legal, financial, and medical risks that are traditionally considered. true/false |
|
Definition
|
|
Term
| Prohibit abusing the system by referring patients to their own services. |
|
Definition
| Physician self-referral prohibitions |
|
|
Term
| __________ involves submitting a bill for a higher level of reimbursement than actually rendered in order to receive a higher reimbursement rate. |
|
Definition
|
|
Term
| Involves submitting a bill for a higher level of reimbrusement than actually rendered in order to receive a higher reimbursement rate. |
|
Definition
|
|
Term
| ___________ actions allow private plaintiffs to sue on behalf of the US government and receive a portion of the recovered funds if successful. |
|
Definition
|
|
Term
| Physician self-referral prohibitions refers to physicians abusing the system by referring patients to their own services. true/false |
|
Definition
|
|
Term
|
Definition
| A false misrepresentation of fact that is relied on by another to that person's detriment and is a departure from reasonable use. This false misrepresentation of fact may take the form of words or conduct. |
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Term
|
Definition
| Submitting a bill for a higher level of reimbrusement than actually rendered in order to receive a higher reimbursement. |
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|
Term
|
Definition
| Submitting separate bills for each component of a procedure instead of using theproper procedural code for the entire procedure, resulting in a higher reimbursementrate to the health-care provider |
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|
Term
|
Definition
| Lawsuits that allow private plaintiffs to sue on behalf of the US government and receive a portion of the recovered funds if successful |
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Term
|
Definition
| Generally, a current or former employee of a health-care provider or organization who has learned of fraud and abuse and wishes to expose the activity. |
|
|
Term
| Fraud and abuse allow private plaintiffs to sue on behalf of the US government and receive a portion of the recovered funds if successful. true/false |
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Definition
|
|
Term
| __________ statues prohibit the use of the US Postal Service or commercial wire services for the advancement of a scheme relating to fraud. |
|
Definition
|
|
Term
| These statutes proibit the use of the US Postal Service or commercial wire services for the advancement of a scheme relating to fraud. |
|
Definition
| Mail and wire fraud statutes |
|
|
Term
| Physician _____________ prohibitions refer to physicians abusing the system by referring patients to their own services. |
|
Definition
|
|
Term
| Disclosures That Do Not Require Tracking |
|
Definition
1. Disclosures made for treatment, payment, and healthcare operations purposes.
2. Disclosures made to the individual.
3. Disclosures made for directory purposes.
4. Disclosures made to person involved in the individual's care.
5. Disclosures made for national security or intelligence purposes.
6. Disclosures to correctional institutions or law enforcement officials.
7. Disclosure made priror to the date of compliance with the privacy standards. |
|
|
Term
| Required Content of the Accounting (disclosure) |
|
Definition
* Date of disclosure
* Name and address, if known, of the entity or person who received the PHI
* Brief description of the PHI disclosed
* Brief statement of purpose that reasonably informs the individual of the purpose or a copy of the authorization or a copy of the written request for disclosure
* If multiple disclosures are made to the same entity or person for the same reason, it is not necessary to document items 1-4 for each disclosure. The covered entity may document instead the first disclosure, the frequency or number of disclosures made during the accounting period, and the date of the last disclosure for the accounting period. |
|
|
Term
| Upon request, the entity must provide the individual with a written accounting of disclosures for the ______ years prior to the date of the request. The time period requested can be less than six years. |
|
Definition
|
|
Term
| A document that shows what data and records were destroyed, who destroyed those data and records, and the method used for that destruction. |
|
Definition
| Certificate of destruction |
|
|
Term
| Record retention schedules are the general principles determing the length of time health data, and the health records in which those data are stored, must be maintained by the health-care provider. true/false |
|
Definition
|
|
Term
| Patient-specific information is an abstract of health information that is always contained in an electronic health record. true/false |
|
Definition
|
|
Term
| _________ identifies the health care provider who has made the entry in writing or by dictation, keyboard, or keyless data entry. |
|
Definition
|
|
Term
| _________ policies are the general principles determing the lenth of time health data, and the health records in which those data are stored, must be maintained by the health-care provider. |
|
Definition
|
|
Term
| Legal doctrine that requires healthcare providers to disclose information to the patient about treatment options and risks so that the patient may knowledgeably consent to treatment. |
|
Definition
|
|
Term
|
Definition
| The characteristics essential to constitute an adequate health record. |
|
|
Term
| Open record statues is a statutory provision that addresses confidentiality requirements using a presumption of disclosure of information upon request, absent statutory exemption. true/false |
|
Definition
|
|
Term
|
Definition
| A document that contains a complete and accurate description of a patient's history, condition, diagnostic and therapeutic treatment, and the results of treatment. |
|
|
Term
|
Definition
| health records that are based partially in paper form and partially in electronic form |
|
|
Term
| Draw a single line through the entry and write "error" next to it, along with the date, time and initials of the person who made the error. You do this when: |
|
Definition
| Corrections to the record |
|
|
Term
| The __________ is a document that details what data will be retained, the retention period, and the manner in which the data will be stored. |
|
Definition
| Record retention schedule |
|
|
Term
| ___________ to the record involve drawing a single line through the entry and writing "error" next to it, along with the date, time and initials of the person who made the error. |
|
Definition
|
|
Term
| A document that contains a complete and accurate description of a patient's history, condition, diagnostic and therapeutic treatment, and the results of treatment. |
|
Definition
|
|
Term
| De-identified health information refers to data with all identifiers removed so that no one can reasonable identify the patient based on what remains. true/false |
|
Definition
|
|
Term
| The right to be left alone or the right to control personal information. |
|
Definition
|
|
Term
| Informed consent is the obligation of the health care provider to maintain patient information in a manner that will not permit dissemination beyond the health care provider. true/false |
|
Definition
|
|
Term
| Standards of conduct issued by professional organizations to guide their members' future course of action, are called ethical guidelines. true/false |
|
Definition
|
|
Term
| A living will allows a competent individual to name someone else to exercise decisions on his or her behalf in the event the individual becomes incapacitated or unable to make personal decisions. true/false |
|
Definition
|
|
Term
| ____________ is the obligation of the health care provider to maintain patient information in a manner that will not permit dissemination beyond the health care provider. |
|
Definition
|
|
Term
|
Definition
| Written instructions recognized under state law, such as living wills or durable powers of attorney for health care, that relate to the kind of health care the patient wishes to have or not have if he or she becomes incapacitated. |
|
|
Term
|
Definition
| The obligation of the health-care provider to maintain patient information in a manner that will not permit dissemination beyond the health-care provider. The origin of confidentiality is found in the Hippocratic Oath |
|
|
Term
| De-identified health information |
|
Definition
| Health information that is stripped of all identifiers. |
|
|
Term
| Durable power of attorney |
|
Definition
| Allows a competent individual to name someone else to exercise health-care related decisions on his or her behalf, in the event hte individual becomes incapacitated or unable to make personal decisions. This term is sometimes referred to in a shorten fashion as druable power of attorney. |
|
|
Term
|
Definition
| Standards of conduct issued by professional organizations to guide their member's future course of action. These standards are sometimes used to establish the standard of care in a negligence action. |
|
|
Term
| __________ is a statutory provision that addresses confidentiality requirements using a presumption of disclosure of information upon request, absent statutory exemption. |
|
Definition
|
|
Term
|
Definition
| the voluntary agreement by a mentally competent person to allow something proposed by another to be performed on him/herself. |
|
|
Term
|
Definition
| express content, implied content, informed consent |
|
|
Term
|
Definition
| can be either verbal or written. because a verbal consent may be difficult to corroborate in a lawsuit, the best practice is to obtain a patient's consent in writing. |
|
|
Term
|
Definition
| consent assumed in emergency situations that threaten life or limb. |
|
|
Term
|
Definition
| Written consent from the patient after he/she has been adequately informed about the proposed procedure. |
|
|
Term
| Recommended content of informed consent |
|
Definition
* The nature and purpose of the proposed procedure.
* The risks and benefits of the proposed procedure
* Any reasonable alternatives to the proposed procedure
* Any risks of refusing the proposed procedure |
|
|
Term
| _________ standards address evidence of informed consent in the patient's health records. |
|
Definition
|
|
Term
|
Definition
| Documented upon admission to services |
|
|
Term
|
Definition
| used for unusual or infrequent procedures and can be multiple pages and complicated to read. used for research and human experimentation, photos and videos, autopsy, and anatomical gifts |
|
|
Term
| "The right to privacy is a personal and fundamental right protected by the Constitution of the United States" is found in |
|
Definition
|
|
Term
| The Privacy Act of 1974 was enacted to protect the privacy of individuals identified in information systems maintained by... |
|
Definition
| federal agencies, such as the VA and Indian Health Services. |
|
|
Term
| The Uniform Health Care Information Act of 1985 was enacted to... |
|
Definition
| bring uniformity to state law. prohibits distribution of patient information to third parties wo the pt's authorization. does provide for pts to have access to their health information and to request correction or amendment to that information. Was not successful in its purpose of standardization. HIPAA has subsequently stepped in. |
|
|
Term
|
Definition
| establishes that covered entitites must have established patient rights policies; when and how a pt should be fully informed of these rights; and ensure the pt understands these rights. This requirement is met with the Notice of Privacy Practices (a.k.a Notice of Information Practices). |
|
|
Term
| Notice of Privacy Practices (NPP) |
|
Definition
| A CE notifies the pt of uses and disclosurs of health information that may be made and the pt's right to consent, reject, or request restrictions of the health information for any and all of the many uses the record serves. |
|
|
Term
| Upon receiving a completed request for amendment form from a patient, the maximum time period to respond per HIPAA is: |
|
Definition
| Within 60 days of receipt with an option of a one-time extension of up to 30 days. |
|
|
Term
| Examples of 3rd party access are: |
|
Definition
| worker's comp, durable power of attorney, need to know, accreditation agency surveyors, licensing agencies, certain research activities, mandatory reporting requirements, organ and tissue transplant services. |
|
|
Term
| Minor are considered "incompetent" except in cases of |
|
Definition
| emancipation, treatment for certain conditions (STDs, pregnancy, substance abuse). |
|
|
Term
| There are _____ required elements for an authorization to disclose patient health information. |
|
Definition
|
|
Term
| Common defects of an Invalid ROI form |
|
Definition
* The expiration date has passed, or the expiration event is known by the health-care provicer to have occurred
* Authorization has not been filled out completely with respect to a core element.
* Authorization is known by the health-care provicer to have been revoked
* Auhorization lacks a core element
* Aurhotization contains a compound authorization violation
* Any material information contained in the authorization is known by the health-care provider to be false. |
|
|
Term
| Except where a consent or authorization clearly ibdicates otherwise, disclosures of information made pursuant to a valid authorization will be for information orginated _________ the authorization was signed. |
|
Definition
| on or before. ( in other words, an individual cannot sign an authorization on 10/6/11 to release information dated November 1, 2011. An individual cannot authorize release of information that has not occurred yet) |
|
|
Term
| Except as otherwise required by federal or state law or regulation, or specified int he authorization itself, an authorization will expire no later than _______ months after it is signed. |
|
Definition
|
|
Term
| Minimum necessary standard |
|
Definition
| The standard requires the helath-care provider to make reasonable efforts to limit the patient-specific health information to the minimum necessary to accomplish the intended purpose of the use, disclosure, or request. |
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Term
| When research is performed w/o an individual's authorization, the CE must obtain one of these four things: |
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Definition
* IRB approval
* Representations from the researcher that the use or disclosure of the PHI is solely to prepare a research protocol for similar purposes preparatory to research
* Representations from the researcher that use or disclosure is solely for reasearch on teh PHI of decedents
* Limited data set use agreement entered into by both the CE and researcher. |
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Term
| When a patient expires, their PHI is accessible for research purposes _______ an authorization. |
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Definition
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Term
| Limited data sets exclude ______. |
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Definition
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Term
| Information that does not need to be included on accounting of ROI |
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Definition
* Disclosures that occurred prior to when HIPAA became effective (4-14-03)
* Disclosures that occured more than 6 years prior to the date of the request for accounting for disclosure.
* Those authorized by patient |
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Term
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Definition
| a duty to disclose information (w/o authorization) to warn an intended victim when a pt threatens to harm an indivually indentifiable victim and the mental health provider believes that the pt is likely to actualy harm the victim. |
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Term
| Redisclosure as related to substance abuse records |
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Definition
| The Confidentiality of Alcohol and Drug Abuse Patient Records rules prohibit redisclosure of health information. |
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Term
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Definition
| about reducing risk and subsequent liability for injuries (loss) that occur in the CEs immediate environment. |
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Term
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Definition
| Any occurence that might result in loss |
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Term
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Definition
| Any damage to a person, property, or rights. This may include physical injury, cognitive injury, emotional injury, wrongful death, financial loss, etc. |
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Term
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Definition
| Oversees the medical staff bylaws (MSB) in which the various membership categories of the medical staff, e.g. active, courtesy, consultative, etc, are described as well as the process for obtaining privileges. |
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Term
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Definition
| Oversees the application process for medical staff applicants, requests for clinical privileges, and re-appointments to the medical staff. The committee makes its recommendations to the Executive Committee. |
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Term
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Definition
| Oversees the activities of the medical staff. It is responsible for recommending to the governing body new medical staff appointments and medical staff re-appointments for approval. As such, the governing body has the responsibility for ultimate approval of all medical staff. |
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Term
| Are incident reports kept in the medical record? |
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Definition
| No. It may prevent discoverability or admissibility as evidence in the event of litigation. How? through the application of privileges--specifically the invocation of the attorney-client (CE) privilege. Depending on the legal jurisdiction, if the incident report has not been placed in the medical record and dissemination has been limited to legal counsel and the liability insurance carrier, then it is protected. |
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Term
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Definition
| Governments primary litigation tool for combating fraud. It provides that anyone who knowingly submits false claims to the government is liable for damages up to three times the amount of the erroneous payment plus mandatory penalties between $5,500 and $11,000 for each false claim submitted. In addition a whistle-blower generall receives 15 to 25% (or more) of the government's recovery plus reimbursement of legal fees and expenses. If the whistle-blower's employment was latered as a result of reporting the alleged fraud, he/she is entitled to remedies that include reinstatment of job, two times the amount of any back pay, interest on any back pay, and compensation for any special damages sustained as a result of job alteration, including litigation costs and reasonable attorneys' fees. |
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Term
| Corporate compliance programs |
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Definition
| became poprular after Federal Sentencing Guidelines were adopted by the US Sentencing Commission in 1991. The guidelines reduce fines and penalties to an organization found guilty of healthcare fraud if the organization has a fraud prevention and detection program in place. |
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