• Home
  • Textbooks
  • McGraw-Hill Specialty Board Review Pain Medicine
  • Cost, Ethics, and Medicolegal Aspects in Pain Medicine

McGraw-Hill Specialty Board Review Pain Medicine

Salahadin Abdi, Pradeep Chopra, Howard Smith

Chapter 13

Cost, Ethics, and Medicolegal Aspects in Pain Medicine - all with Video Answers

Educators


Chapter Questions

Problem 901

What are the penalties under the False Claims Act?
(1) Three times the amount of damages suffered by the government
(2) A mandatory civil penalty of at least $$\$ 5500$$ and no more than $$\$ 11,000$$ per claim
(3) Submit 50 false claims for $$\$ 50$$ each (liability between $$\$ 282,500$$ and $$\$ 557,500$$ in damages)
(4) Program exclusion

Check back soon!

Problem 902

What are the steps to compliance of security standards for electronic patient records?
(1) Administrative safeguards
(2) Physical safeguard
(3) Technical safeguard
(4) Financial viability safeguard

Check back soon!

Problem 903

Identify all accurate statements:
(1) The Emergency Medical Treatment and Active Labor Act (EMTALA) only applied to patients who are physically in a hospital's emergency department
(2) Physicians in a group practice may receive productivity bonuses without violating
the Stark Self-Referral Rules if the bonuses are based on a physician's total number of patient encounters or relative value units (RVUs)
(3) You purchase a medical practice that is currently subject to a corporate integrity agreement (CIA), and the transfer of ownership will void the CIA
(4) According to the Department of Health and Human Services Office of Inspector General (OIG), having a compliance program without appropriate, ongoing monitoring is worse than not having a compliance program

Check back soon!
01:12

Problem 904

Local medical review policy (LMRP) or local coverage determination (LCD) is utilized in all states. Which of the following is (are) true?
(1) LMRP or LCD is developed to assure beneficiary access to care
(2) Frequent denials indicate a need for development of LMRP or LCD
(3) A need for development of LMRP or LCD includes a validated widespread problem
(4) LMRPs or LCDs are the policies used to make coverage and coding decisions in the absence of specific statute, regulations, national coverage policy, and national coding policy or as an adjunct to a national coverage policy

Julian Wong
Julian Wong
Numerade Educator

Problem 905

True statements about qui tam (Whistleblower Act) are as follows:
(1) Suits are usually brought by employees
(2) If the government proceeds with the suit, the whistleblower receives $50 \%$ to $60 \%$ of settlement
(3) Individuals can bring suit against violators of federal laws on their own behalf as well as the government's
(4) If the government does not proceed and the individual continues, the individual receives $100 \%$ of the settlement

Check back soon!

Problem 906

Identify true statement(s) differentiating consultation and referral visit:
(1) Written request for opinion or advice received from attending physician, including the specific reason the consultation is requested
(2) Patient appointment made for the purpose of providing treatment or management or other diagnostic or therapeutic services
(3) Only opinion or advice is sought. Subsequent to the opinion, treatment may be initiated in the same encounter if criteria are fulfilled
(4) Transfer of total patient care for management of the specified condition

Check back soon!
02:06

Problem 907

What are some of the important aspects of documentation of medical necessity?
(1) Medicare will reimburse irrespective of the procedure, furnished, not for improvement function, but $20 \%$ pain relief
(2) The physician practice should be able to provide documentation such as a patient's medical records and physician's orders, to support the appropriateness of a service that the physician has provided
(3) Medicare concurs with physician opinion and patient request with respect to duration, frequency, and setting a procedure performed
(4) The physician practice should only bill those services that meet the Medicare standard of being reasonable and necessary for the diagnosis and treatment of a patient

Alejandro Ruiz
Alejandro Ruiz
Numerade Educator

Problem 908

What is (are) the correct statement(s) about a deficient (dated) practitioner?
(1) Too busy to keep up with CME
(2) Only aware of a few treatments or medications
(3) Prescribes for friends or family without a patient record
(4) Well aware of controlled-drug categories

Check back soon!

Problem 909

Identify accurate statement(s) about clinical policies:
(1) They are expensive and labor intensive to develop and maintain
(2) The actual impact on the quality of care is nearly impossible to determine
(3) There are probable multiple indirect positive benefits of this effort with improved patient care and decreased practice variation
(4) They provide an inordinate amount of restrictions

Check back soon!

Problem 910

What are the Federation of State Medical Board's guidelines for the treatment of pain?
(1) Use of controlled substances, including opiates may be essential in the treatment of pain
(2) Effective pain management is a part of quality medical practice
(3) Patients with a history of substance abuse may require monitoring, consultation, referral, and extra documentation
(4) MDs should not fear disciplinary action for legitimate medical purposes

Check back soon!

Problem 911

Exclusion means which of the following for a provider?
(1) A prohibition from providing health care services for a period of time
(2) A prohibition from billing federal health programs for items or services
(3) A prohibition from practicing as a physician for a period of time
(4) A prohibition from receiving reimbursement from federal health care programs for items or services

Check back soon!