CMOM-Practice Management Institute
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/. HIPPA REGULATION: Privacy Overview - Answer-✅There are three major areas
addressed in the Privacy Regulation: 1. Use and disclosure of PHI, 2. Patient rights 3.
Security administrative and physical
/.Business Associates - Answer-✅can be held directly accountable by federal or state
authority for failure to comply with HIPAA statutory or regulations. ex. IT techs, Janitors,
Cleaning Services, Vendors, Collection agencies, Consultants and Billing Services.
/.Entities - Answer-✅ex. doctors, hospitals, pharmacy
/.Breach - Answer-✅unauthorized acquisition access, use or disclosure of protected
health information, ex. ALGH issue on breach where health info was spread with no
consents from patients.
/.What is NOT considered a breach? - Answer-✅1. Where an authorized person who
received the health info. cannot reasonably have been able to retain it.
2. If an unintentional acquisition, access, or use occurs within the scope of employ. and
info doesn't go any further.
3. If it is an inadvertent disclosure that occurs within a facility, and the information does
not go any further.
/.Tiered Increase in Civil Monetary Penalties - Answer-✅HIPPA violation at $50,000 per
violation and an annual maximum of $1.5million.
/.What are examples that could not result in HIPPA violation by DHHS? - Answer-✅-
Overheard phone or nursing station conversation
-Joint treatment areas
, -Sign-in sheets
-Calling names in reception areas
-Hospital rounds
Solutions would be to speak quietly, cubicles, curtains, dividers, asking patients to step
back, or closing doors.
/.Health Information (PHI) - Answer-✅Any info. whether oral or recorded in any form or
medium that is created or received by a health care provider, health, plan public health
authority, employer, life insurer, school or university, or health care clearinghouse, and
related to the past, present or future physical or mental health or condition.
/.Individual Identifiable Health Information (IIHI) - Answer-✅Information that is a subset
of health information, including demographic, information collected from an individual.
/.Identifiers - Answer-✅-Email address
-Social Security number
-Medical record number
-Vehicle identifier
-Full face photograph
/.The Notice of Privacy Practices should be... - Answer-✅In a written language, tape, or
video that the patient understands, be clearly posted in the practice or facility, and if
applicable, on the practice website.
/.Fraud - Answer-✅the intentional deception or misrepresentation that an individual
knows to be false or does not believe to be true and makes, knowingly that the
deception could result in some unauthorized benefit to himself/herself or some other
person.
ex. Billing for services that were not furnished and or supplies that were not provided
-Billing for services as if performed by a particular entity when they were, in fact,
performed by another entity not eligible to be paid by Medicare
-Using in incorrect or inappropriate provider number ni order to be paid (using a
deceased provider number to defraud Medicare).
/.Abuse - Answer-✅describes practices that either directly or indirectly result in
unnecessary costs to the Medicare Program. Acts committed knowingly, willfully and
intentionally.
ex. Charging in excess for services or supplies
Providing medical unnecessary services
/.Whistleblower - Answer-✅or the "qui tam" provision as it is formally called allows a
person that has knowledge of a false claim against the government to bring an action
against the suspected wrongdoer on behalf of the U.S. government.
EXAM (2025) UPDATE Verified
Questions And Answers | With Correct
Answers graded A+ Guaranteed
Success!!
/. HIPPA REGULATION: Privacy Overview - Answer-✅There are three major areas
addressed in the Privacy Regulation: 1. Use and disclosure of PHI, 2. Patient rights 3.
Security administrative and physical
/.Business Associates - Answer-✅can be held directly accountable by federal or state
authority for failure to comply with HIPAA statutory or regulations. ex. IT techs, Janitors,
Cleaning Services, Vendors, Collection agencies, Consultants and Billing Services.
/.Entities - Answer-✅ex. doctors, hospitals, pharmacy
/.Breach - Answer-✅unauthorized acquisition access, use or disclosure of protected
health information, ex. ALGH issue on breach where health info was spread with no
consents from patients.
/.What is NOT considered a breach? - Answer-✅1. Where an authorized person who
received the health info. cannot reasonably have been able to retain it.
2. If an unintentional acquisition, access, or use occurs within the scope of employ. and
info doesn't go any further.
3. If it is an inadvertent disclosure that occurs within a facility, and the information does
not go any further.
/.Tiered Increase in Civil Monetary Penalties - Answer-✅HIPPA violation at $50,000 per
violation and an annual maximum of $1.5million.
/.What are examples that could not result in HIPPA violation by DHHS? - Answer-✅-
Overheard phone or nursing station conversation
-Joint treatment areas
, -Sign-in sheets
-Calling names in reception areas
-Hospital rounds
Solutions would be to speak quietly, cubicles, curtains, dividers, asking patients to step
back, or closing doors.
/.Health Information (PHI) - Answer-✅Any info. whether oral or recorded in any form or
medium that is created or received by a health care provider, health, plan public health
authority, employer, life insurer, school or university, or health care clearinghouse, and
related to the past, present or future physical or mental health or condition.
/.Individual Identifiable Health Information (IIHI) - Answer-✅Information that is a subset
of health information, including demographic, information collected from an individual.
/.Identifiers - Answer-✅-Email address
-Social Security number
-Medical record number
-Vehicle identifier
-Full face photograph
/.The Notice of Privacy Practices should be... - Answer-✅In a written language, tape, or
video that the patient understands, be clearly posted in the practice or facility, and if
applicable, on the practice website.
/.Fraud - Answer-✅the intentional deception or misrepresentation that an individual
knows to be false or does not believe to be true and makes, knowingly that the
deception could result in some unauthorized benefit to himself/herself or some other
person.
ex. Billing for services that were not furnished and or supplies that were not provided
-Billing for services as if performed by a particular entity when they were, in fact,
performed by another entity not eligible to be paid by Medicare
-Using in incorrect or inappropriate provider number ni order to be paid (using a
deceased provider number to defraud Medicare).
/.Abuse - Answer-✅describes practices that either directly or indirectly result in
unnecessary costs to the Medicare Program. Acts committed knowingly, willfully and
intentionally.
ex. Charging in excess for services or supplies
Providing medical unnecessary services
/.Whistleblower - Answer-✅or the "qui tam" provision as it is formally called allows a
person that has knowledge of a false claim against the government to bring an action
against the suspected wrongdoer on behalf of the U.S. government.
