Module 3 CMAA
While federal laws are mandated, accrediting organizations are a framework of health care standards
that regulate patient safety standards, such as the - correct answer ✔✔National Patient Safety Goals
(NPSG) and The Joint Commission (TJC).
Health Insurance Portability and Accountability Act (HIPAA) - correct answer ✔✔Federal law that ensures
confidentiality of protected health information and sets the standards for health care code sets and
billing.
informed consent - correct answer ✔✔An oral or written agreement of mutual communication that
ensures the patient has been notified about their health care choices before making them.
abuse - correct answer ✔✔Any practice that may result in unnecessary costs to Medicare.
Its important for a CMAA to inform the patient of : - correct answer ✔✔notice of privacy practices, pts
rights, authorization to release medical records.
Providing health care to patients includes protecting their private health information and demographic
details from anyone who does not need access to it. What are some of the ways this is accomplished? -
correct answer ✔✔Patients' protected health information is kept secure by an organizational policy that
considers the nature of their providers and patients—along with other regulatory entities and state and
federal laws. Medical law, ethics, and compliance are the framework for safeguarding patient
information.
Laws - correct answer ✔✔are an obligation imposed by the authority to protect patients, providers, and
property, and non-compliance may lead to punishment. For example, the Food and Drug Administration
(FDA) is a federal regulatory agency that protects people and animals from food, drugs, medical devices,
and other products.
Regulations - correct answer ✔✔are rules or orders issued by an executive authority or regulatory
agency of a government with the force of law. An example of health care regulation is the Healthcare
Quality Improvement Act (HCQIA), which gives immunity to medical providers who do peer reviews to
investigate potential fraud or abuse.
,Guidelines - correct answer ✔✔are written recommendations of policy. For example, the official medical
coding guidelines provide rules and conventions that support correct code assignment.
Policies - correct answer ✔✔are written documents that specify responsibilities among boards,
management, and medical staff. Health care organizations use health and safety policies to define how
health care services are provided to their patients.
Standards - correct answer ✔✔are criteria and practices established by authority as rules for measuring
value, extent, or quality. Ethical standards are an expectation of health care organizations and medical
professionals.
Occupational Safety and Health Administration (OSHA) - correct answer ✔✔Enforces safety, a healthy
workplace, and training.
The Joint Commission (TJC) - correct answer ✔✔Seeks to improve health care for the public, in
collaboration with stakeholders, by evaluating health care organizations.
National Patient Safety Goals (NPSG) - correct answer ✔✔Aims to improve patient safety.
Centers for Medicare and Medicaid Serves (CMS) - correct answer ✔✔Ensures standards in federally
funded medical programs are followed.
Office of the Inspector General (OIG) - correct answer ✔✔Investigates all fraud and abuse cases
suspected or reported for federally funded medical programs.
Americans with Disabilities Act Amendments Act (ADAAA) - correct answer ✔✔Ensures policies and
practices that define disability, with the aim of protecting people who have disabilities from
discrimination.
Compliance - correct answer ✔✔Following mandated laws, policies, standards, and guidelines.
, Medical Law - correct answer ✔✔explains the rights and responsibilities of medical providers and
patients. There are many components to the medical-legal relationship of patient care, and
understanding concepts of medical law is the responsibility of everyone on the health care team.
Medical laws protect patient and provider rights and set a precedence of expectations between the
patient and the providers through various forms of contracts.
Contracts - correct answer ✔✔are legally binding agreements, such as a managed care organization
contract between a provider and a third-party payer.
Medical laws are created to - correct answer ✔✔protect patients from harm and malpractice.
Malpractice comes in many forms, such as - correct answer ✔✔patient abandonment or negligence.
Patient Abandonment - correct answer ✔✔is a form of malpractice that occurs when a provider stops
treating a patient without a reasonable cause or reasonable notice
What is a reasonable notice in health care so a doctor isn't charged with pt abandonment? - correct
answer ✔✔The reasonable notice includes sending written notice by certified mail with a return receipt.
Patient abandonment can be harmful because it could lead to a lapse in the patient's medical care,
which can include monitoring, medications, and/or medical procedures and can be detrimental to the
patient's health.
Negligence - correct answer ✔✔occurs when a patient does not receive adequate and appropriate care,
which leads to suffering and harm
Malpractice - correct answer ✔✔Any treatment by a medical professional that does not follow the
standards of care.
Healh care providers are mandated reporters? T or F - correct answer ✔✔T
Government-funded programs include - correct answer ✔✔Medicare
Medicaid
State Children's Health Insurance Program (SCHIP)
While federal laws are mandated, accrediting organizations are a framework of health care standards
that regulate patient safety standards, such as the - correct answer ✔✔National Patient Safety Goals
(NPSG) and The Joint Commission (TJC).
Health Insurance Portability and Accountability Act (HIPAA) - correct answer ✔✔Federal law that ensures
confidentiality of protected health information and sets the standards for health care code sets and
billing.
informed consent - correct answer ✔✔An oral or written agreement of mutual communication that
ensures the patient has been notified about their health care choices before making them.
abuse - correct answer ✔✔Any practice that may result in unnecessary costs to Medicare.
Its important for a CMAA to inform the patient of : - correct answer ✔✔notice of privacy practices, pts
rights, authorization to release medical records.
Providing health care to patients includes protecting their private health information and demographic
details from anyone who does not need access to it. What are some of the ways this is accomplished? -
correct answer ✔✔Patients' protected health information is kept secure by an organizational policy that
considers the nature of their providers and patients—along with other regulatory entities and state and
federal laws. Medical law, ethics, and compliance are the framework for safeguarding patient
information.
Laws - correct answer ✔✔are an obligation imposed by the authority to protect patients, providers, and
property, and non-compliance may lead to punishment. For example, the Food and Drug Administration
(FDA) is a federal regulatory agency that protects people and animals from food, drugs, medical devices,
and other products.
Regulations - correct answer ✔✔are rules or orders issued by an executive authority or regulatory
agency of a government with the force of law. An example of health care regulation is the Healthcare
Quality Improvement Act (HCQIA), which gives immunity to medical providers who do peer reviews to
investigate potential fraud or abuse.
,Guidelines - correct answer ✔✔are written recommendations of policy. For example, the official medical
coding guidelines provide rules and conventions that support correct code assignment.
Policies - correct answer ✔✔are written documents that specify responsibilities among boards,
management, and medical staff. Health care organizations use health and safety policies to define how
health care services are provided to their patients.
Standards - correct answer ✔✔are criteria and practices established by authority as rules for measuring
value, extent, or quality. Ethical standards are an expectation of health care organizations and medical
professionals.
Occupational Safety and Health Administration (OSHA) - correct answer ✔✔Enforces safety, a healthy
workplace, and training.
The Joint Commission (TJC) - correct answer ✔✔Seeks to improve health care for the public, in
collaboration with stakeholders, by evaluating health care organizations.
National Patient Safety Goals (NPSG) - correct answer ✔✔Aims to improve patient safety.
Centers for Medicare and Medicaid Serves (CMS) - correct answer ✔✔Ensures standards in federally
funded medical programs are followed.
Office of the Inspector General (OIG) - correct answer ✔✔Investigates all fraud and abuse cases
suspected or reported for federally funded medical programs.
Americans with Disabilities Act Amendments Act (ADAAA) - correct answer ✔✔Ensures policies and
practices that define disability, with the aim of protecting people who have disabilities from
discrimination.
Compliance - correct answer ✔✔Following mandated laws, policies, standards, and guidelines.
, Medical Law - correct answer ✔✔explains the rights and responsibilities of medical providers and
patients. There are many components to the medical-legal relationship of patient care, and
understanding concepts of medical law is the responsibility of everyone on the health care team.
Medical laws protect patient and provider rights and set a precedence of expectations between the
patient and the providers through various forms of contracts.
Contracts - correct answer ✔✔are legally binding agreements, such as a managed care organization
contract between a provider and a third-party payer.
Medical laws are created to - correct answer ✔✔protect patients from harm and malpractice.
Malpractice comes in many forms, such as - correct answer ✔✔patient abandonment or negligence.
Patient Abandonment - correct answer ✔✔is a form of malpractice that occurs when a provider stops
treating a patient without a reasonable cause or reasonable notice
What is a reasonable notice in health care so a doctor isn't charged with pt abandonment? - correct
answer ✔✔The reasonable notice includes sending written notice by certified mail with a return receipt.
Patient abandonment can be harmful because it could lead to a lapse in the patient's medical care,
which can include monitoring, medications, and/or medical procedures and can be detrimental to the
patient's health.
Negligence - correct answer ✔✔occurs when a patient does not receive adequate and appropriate care,
which leads to suffering and harm
Malpractice - correct answer ✔✔Any treatment by a medical professional that does not follow the
standards of care.
Healh care providers are mandated reporters? T or F - correct answer ✔✔T
Government-funded programs include - correct answer ✔✔Medicare
Medicaid
State Children's Health Insurance Program (SCHIP)
