CPHRM CORRECT EXAMS QUESTIONS AND
ANSWERS SET A+
✔✔Outline requirements for a HIPAA-complaint authorization - ✔✔HIPAA-complaint
authorization for release of info must have the following elements:
➣ description of info to be disclosed
➣ identification of covered entity who is making the disclosure
➣ Identification of person/entity to whom disclosure will be made
➣ purpose of disclosure
➣ patient's signature and date (or authorized legal rep)
➣ two key statements:
1. statement regarding patient's rights to revoke the authorization
2. statement advising of the possibility that the PHI could be re-disclosed by the
recipient, which we have not control over.
✔✔Discuss penalties for violating EMTALA - ✔✔CMS and OIG have enforcement
power. Penalties may include:
➣ termination of facility's Medicare agreement
➣ fines up to $119K per violation($59K for hospitals with <100 beds) fees are updated
every year by inflation***
➣ Physician fines $119K per violation including on-call physicians
➣ Civil lawsuit by a patient
➣ Civil lawsuit by the receiving facility as a result of a patient transfer violation
➣ Civil monetary penalties up to $50,000 for failure to report another facility suspected
of having violated EMTALA.
See 42 C.F.R § 489.24, 42 C.F.R. § 1003.103(e); 45 C.F.R. § 102.3).
✔✔Discuss the handling of medical devices involved in a patient safety event -
✔✔Guidelines:
, ➣ remove the medical device from service and secure it. Label it with pertinent info for
future identification.
➣ do not clean, test, or alter the device.
➣ take photos
➣ determine the process for device and equipment service/maintenance.
➣ secure any contracts for rental, purchase, maintenance of the device. See device
reference manual for any recommendations.
➣ Track medical device alert and FDA or other agency recall notices (internal system).
Facility tracking logs/system should be queried to see if there has been prior
notifications or alerts. And check the FDA site of current device alerts.
➣ consult with risk management, legal counsel, biomedical expert to determine if device
needs further evaluation or repairs to return to service safely.
➣ If applicable, report any adverse event in accordance with the Safe Medical Device
Act (SMDA) requirements.
✔✔Discuss Stark Law, intent and enforcement provisions - ✔✔Stark Law (physician
self-referral)
Civil statute that prohibits physicians from referring Medicare or Medicaid patients to
entities for designated health services (DHS) in which the physician or an immediate
family member has a financial relationship
Note, that this law is a strict liability (no intent to prove), where physicians will be found
liable regardless of their intent or knowledge for self-referring.
DHS include:
Clinical laboratory services
Physical therapy and occupational therapy services
Speech-language pathology services
Radiology and certain other imaging services
Radiation therapy services: and supplies
Durable medical equipment (DME): and supplies
Parenteral and enteral nutrients, equipment, and supplies
Prosthetics, orthotics, and prosthetic devices and supplies
Home health services
Outpatient prescription drugs
Inpatient and outpatient hospital services
For instance,
If a provider is part owner of a lab, and he only refers patient to his lab, and does not
provide patients with choices, provider will be violating the Stark law and penalties up to
$15,000 per service referred and up to $100,000 for each circumvention scheme, 42
CFR Part 402.
Other violations may apply, such as the Anti-kickback and the False Claims Act.
✔✔Discuss the anti-kickback stature, including enforcement provisions - ✔✔Anti-
Kickback Statute (AKS)
ANSWERS SET A+
✔✔Outline requirements for a HIPAA-complaint authorization - ✔✔HIPAA-complaint
authorization for release of info must have the following elements:
➣ description of info to be disclosed
➣ identification of covered entity who is making the disclosure
➣ Identification of person/entity to whom disclosure will be made
➣ purpose of disclosure
➣ patient's signature and date (or authorized legal rep)
➣ two key statements:
1. statement regarding patient's rights to revoke the authorization
2. statement advising of the possibility that the PHI could be re-disclosed by the
recipient, which we have not control over.
✔✔Discuss penalties for violating EMTALA - ✔✔CMS and OIG have enforcement
power. Penalties may include:
➣ termination of facility's Medicare agreement
➣ fines up to $119K per violation($59K for hospitals with <100 beds) fees are updated
every year by inflation***
➣ Physician fines $119K per violation including on-call physicians
➣ Civil lawsuit by a patient
➣ Civil lawsuit by the receiving facility as a result of a patient transfer violation
➣ Civil monetary penalties up to $50,000 for failure to report another facility suspected
of having violated EMTALA.
See 42 C.F.R § 489.24, 42 C.F.R. § 1003.103(e); 45 C.F.R. § 102.3).
✔✔Discuss the handling of medical devices involved in a patient safety event -
✔✔Guidelines:
, ➣ remove the medical device from service and secure it. Label it with pertinent info for
future identification.
➣ do not clean, test, or alter the device.
➣ take photos
➣ determine the process for device and equipment service/maintenance.
➣ secure any contracts for rental, purchase, maintenance of the device. See device
reference manual for any recommendations.
➣ Track medical device alert and FDA or other agency recall notices (internal system).
Facility tracking logs/system should be queried to see if there has been prior
notifications or alerts. And check the FDA site of current device alerts.
➣ consult with risk management, legal counsel, biomedical expert to determine if device
needs further evaluation or repairs to return to service safely.
➣ If applicable, report any adverse event in accordance with the Safe Medical Device
Act (SMDA) requirements.
✔✔Discuss Stark Law, intent and enforcement provisions - ✔✔Stark Law (physician
self-referral)
Civil statute that prohibits physicians from referring Medicare or Medicaid patients to
entities for designated health services (DHS) in which the physician or an immediate
family member has a financial relationship
Note, that this law is a strict liability (no intent to prove), where physicians will be found
liable regardless of their intent or knowledge for self-referring.
DHS include:
Clinical laboratory services
Physical therapy and occupational therapy services
Speech-language pathology services
Radiology and certain other imaging services
Radiation therapy services: and supplies
Durable medical equipment (DME): and supplies
Parenteral and enteral nutrients, equipment, and supplies
Prosthetics, orthotics, and prosthetic devices and supplies
Home health services
Outpatient prescription drugs
Inpatient and outpatient hospital services
For instance,
If a provider is part owner of a lab, and he only refers patient to his lab, and does not
provide patients with choices, provider will be violating the Stark law and penalties up to
$15,000 per service referred and up to $100,000 for each circumvention scheme, 42
CFR Part 402.
Other violations may apply, such as the Anti-kickback and the False Claims Act.
✔✔Discuss the anti-kickback stature, including enforcement provisions - ✔✔Anti-
Kickback Statute (AKS)
