When controlling the type of supply, increasing the amount of generalists could contain costs because.

Generalists earn lower incomes than specialists

Generalists practice resource-intensive medicine and generate lower overall health care expenditures

Generalists use less hospital and laboratory services

The continuous quality improvement model (CQI) seeks to.

develop formalized standards of care

separate financial and clinical decisions

Clinical practice guidelines are often ineffective in improving quality of care because.

they are unsuccessful in influencing physicians' practices

they are not appropriate for many clinical situations

they may conflict with patient preferences

they are unsuccessful in influencing physicians' practices

The malpractice liability system negatively impacts quality of care because.

The fear and stress of malpractice litigation creates an "I didn't do it" response from the physician, rather than working on improvement

The system is economically wasteful and takes dollars away from improving care

It wreaks unnecessary stress on often innocent and talented physicians

The CQI approach of producing health care "report cards," specifically HEDIS is a tool to encourage health care consumers to choose high-quality caregivers, but often.

cost, not quality is the driving motivator for employers to choose health care plans for their employees

these report cards are inaccurate

cost, not quality is the driving motivator for employers to choose health care plans for their employees

HEDIS includes only a limited number of quality performance indicators

Which of the following is a true statement about both the amount and quality of medical services available:

medical services can be overused or underused which can both be detrimental to the quality of care

an increase in medical services also increases the quality of care because it provides greater access to care

minimal medical services is needed for increasing quality of care because it reduces misdiagnoses

medical services can be overused or underused which can both be detrimental to the quality of care

the quantity and quality of care are not related

Under HIPAA, what is the entity that processes healthcare claims and performs related functions for a health plan?

Joint Commission on Accreditation of Healthcare Organizations

When responding to a client's request for information about the disclosure of his/her protected health information, which is NOT required?

Disclosures for treatment, payment, or health care operations

A description of what information was sent

Disclosures for treatment, payment, or health care operations

The dates of disclosure and to whom the information was sent

Part of Administrative Safeguards under HIPAA is Workforce Security measures. Which is NOT a key element of a Workforce Security Element?

Identification of barriers to client electronic Personal Health Information

What is impact of the HITECH Act in relation to HIPAA requirements and maintaining client records electronically?

There is no requirement to maintain client records electronically, but clients have the right to insist on electronic access to an electronic health record, if it exists

There is a push toward paper records to prevent the hacking and electronic violation of electronic records, which is easily done without detection

Providers must now maintain client records electronically, but may continue to provide clients a paper copy when access is requested

There is no requirement to maintain client records electronically, but clients have the right to insist on electronic access to an electronic health record, if it exists

Electronic records now face intensified scrutiny, requiring practitioners to implement more sophisticated software and detailed accounting of records Your answer: Electronic records now face intensified scrutiny, requiring practitioners to implement more sophisticated software and detailed accounting of records

A therapist's client requests an accounting of disclosures of their medical record. What should that therapist do?

Refer the client to the agency's Privacy Officer

Pull the file with the accounting of disclosures for the client

Explain that disclosures are allowed as long as the client's information is deidentified or the client consents

Refer the client to the agency's Privacy Officer

Review the client's releases of information with the client

Which is NOT consistent with Personnel Clearance Procedures needed to comply with HIPAA Administrative Safeguards?

Appropriate exit interviews for outgoing personnel

Current database of what personnel has access to buildings, offices, filing cabinets, computers, and databases

New employees, contractors, and unpaid staff have references checked

Appropriate exit interviews for outgoing personnel

Discretion given to who does and does not have access to secure office spaces or keys/door codes

Marcus is responsible for security management within a HIPAA-covered entity. He is reviewing administrative safeguards and examining the organization's risk analysis. Which element is NOT part of risk analysis?

Developing adequate communication with all contractors, interns, and staff in relation to the agency's security policies

Assessing vulnerabilities of integrity and availability of electronic personal health information

Determining how client electronic personal health information confidentiality may be compromised

Determining barriers in existence to needed client electronic personal health information

Which is NOT an element of Security Awareness Training?

Procedural issues of who will terminate user access

Determination that all staff will receive security training

Policy related to documentation of all security training

Procedural issues of who will terminate user access

Training on vulnerabilities of the electronic Protected Health Information policies

Under HIPAA Administrative Simplification, what must covered entities do in relation to submission of claims?

Provide standardized electronic claim formatting

Provide standardized format in electronic or paper form

Request permission for use of specific privacy software

Purchase and install approved privacy software

Provide standardized electronic claim formatting

As of 2010, what is different with regard to business associates and HIPAA protections?

Business associates now must notify clients directly of privacy breaches, as if they were a covered entity

There are no significant changes in business associate practices

Covered entities have increase responsibilities to ensure the practice of business associates

Business associates are no longer required to notify clients directly of privacy breaches

HIPAA requires a response and reporting of security incidents. What is required when an organization has an attempted unauthorized access of protected health information?

The organization must respond and notify the appropriate parties

Nothing is required of an attempted unauthorized access

The organization must respond and notify the appropriate parties

Federal authorities must be notified

Under Title II of The Health Insurance Portability and Accountability Act, the administrative simplification provision:

Requires the establishment of national standards for electronic health care transactions

Forbids individual health plans from denying coverage or imposing preexisting condition exclusions

Creates opportunities for fraud and abuse within the health care system

Requires the establishment of national standards for electronic health care transactions

Protects health insurance coverage for workers and their families

What data-related concept identifies or characterizes entities and events in a manner that facilitates an administrative process?

Non-medical or Administrative Code Sets

Title I of The Health Insurance Portability and Accountability Act protects:

Health insurance coverage for workers and their families

Electronic health care transactions

Restrictions that a group health plan can place on benefits for preexisting conditions

Health insurance coverage for workers and their families

Do the same requirements apply to both medical records and mental health records?

Generally, psychotherapy notes are not included in the provision that allows clients to see and copy their health information

No, a client is not allowed to have access to any part of a mental health record, with or without psychotherapy notes

Generally, including conditioning enrollment in a plan on the client granting authorization for disclosure of psychotherapy notes

Yes, and client is entitled to all of the same information in both settings

Generally, psychotherapy notes are not included in the provision that allows clients to see and copy their health information

HIPAA's Administrative Simplification procedures were prompted by the desire to:

Reduce administrative overhead in provider-payer transactions

Simplify administrative functions such as payroll and benefits

Create multiple forms for various transactions

Add more details to the processing of electronic transactions

If a medical entity is in compliance with the Division of Medical Assistance's (DMA's) Health Data Marketing Guidelines, is the entity in compliance with HIPAA guidelines?

No. HIPAA is law while DMA guidelines are not law, and require less than HIPAA

Yes. HIPAA is federal law and DMA is state law, which is usually more restrictive, and the more restrictive standard should be met.

No. HIPAA law is federal and DMA law is state, so HIPAA supersedes DMA law.

Yes. DMA's guidelines are stricter and will supersede those minimum standards of HIPAA.

If a client requests a restriction for disclosure of a certain part of their PHI to a health plan, the health care provider is:

Required to agree to the requested restriction if the disclosure is for treatment or payment, is not required by law, and if the information is specifically related to a health care item or service that the client has paid for in full

Required to agree only if the client specifies why he/she wants the restriction

Required to agree only if the client specifies who he/she wants the restriction to apply to

Required to agree to the requested restriction

February 17, 2010 was the effective date for updated changes to HIPAA triggered by the Health Information Technology for Economic and Clinical Health Act (HITECH). As part of HITECH, what must providers who have clients who opt to self-pay do when those clients request the provider not inform their health care insurance provider?

The provider must not disclose the information to the health care insurance provider

The provider has the option to not disclose the information to the health care insurance provider

The provider must disclose the information anyway to the heath care insurance provider

The provider must not disclose the information to the health care insurance provider

The provider must have the client sign a waiver freeing the provider from the compulsion to report to the provider

HIPAA guidelines say employers that sponsor employee group health plans must maintain privacy of which __________________ in secured locations, if kept in the office?

Enrollment and claim information

Information related to lawsuits again employers

Enrollment and claim information

Administrative Safeguards on Security Awareness related to electronic Protected Health Information (PHI) and Log-in Monitoring includes all, EXCEPT:

Prohibit the sharing of passwords among any employees, paid or unpaid

Review the system's login reports at regular intervals

Prohibit the sharing of passwords among any employees, paid or unpaid

Limit the number of attempts a computer user can make at a log-in attempt

Use of software that locks the user out of the system after a certain number of unsuccessful log-in attempts are made

Sammy applied for and received her National Provider Identifier online. What may she now do?

Be identified as a unique health care provider during HIPAA transactions

Have guaranteed payment by a health plan

Receive credentialing or licensing as a therapist provider

Be guaranteed enrollment as a provider in a health plan

Be identified as a unique health care provider during HIPAA transactions

Breach notification exceptions are provided to all, EXCEPT:

If the information impacted less than 500 people within a single demographic area

Business associates who access information by good faith, unintentional means and do not further disclose information

Unintentional, good faith access by employees of covered entities if the information was not further disclosed

If the information impacted less than 500 people within a single demographic area

Inadvertent disclosure made individual to individual within a covered entity who is authorized to access protected health information

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