Deck 12: Health Policy and Regulation

Question 1

____ is the governmental oversight of the private marketplace.

A) Allegiance
B) Procedure
C) Control
D) Regulation

Answer 1

Regulation

Question 2

With the increasing intersection between health care delivery and the law,health care executives must confront a wide range of regulatory ____________________ issues that affect how health care institutions operate.

Answer 2

compliance

Question 3

To successfully navigate through the complex regulatory environment,health care organizations (HCOs)often appoint a regulatory ____________________.

Answer 3

compliance officer

Question 4

____________________,created by a 1965 statute,is the federal health insurance program for the elderly and disabled.

Question 5

The 1999 report by the Institute of Medicine,To Err Is Human: Building a Safer Health System,stated that between ____ deaths could be attributed to preventable medical errors.

A) 400 and 980
B) 4,000 and 9,800
C) 44,000 and 98,000
D) 440,000 and 980,000

Question 6

The ____ of 1986 is designed to prevent institutions from denying care to anyone seeking emergency medical treatment,regardless of citizenship,insurance status,or ability to pay.

A) Emergency Medical Transfer and Litigation Act (EMTALA)
B) Emergency Medical Treatment and Labor Act (EMTALA)
C) Emergency Medical Treatment and Litigation Act (EMTALA)
D) Emergency Medical Transfer and Labor Act (EMTALA)

Question 7

In many states,a health care facility cannot be constructed,renovated,or expanded without obtaining a ____.

A) contract of negotiation (CON)
B) contract of need (CON)
C) certificate of need (CON)
D) certificate of negotiation (CON)

Question 8

An emerging cost containment strategy is to encourage comparative ____ research.

A) physician output
B) practitioner competency
C) clinical effectiveness
D) health care incentive

Question 9

The Department of Health and Human Services (HHS)____________________,with the cooperation of the Department of Justice,dedicates considerable resources to enforcing federal fraud and abuse laws.

Question 10

A ____ is used by the IRS for assessing whether hospitals are operated to serve a charitable purpose.

A) community reduction standard
B) community benefit standard
C) common benefit structure
D) common reduction structure

Question 11

____________________ principles affect the interaction between federal and state laws,stating that if federal and state laws directly conflict,the federal law applies.

Question 12

"____________________" authority allows the Centers for Medicare and Medicaid Services (CMS)to state that a health care organization meets CMS certification requirements.

Question 13

The ____ (HIPAA)limits the ability of new employers to exclude coverage for preexisting conditions.

A) Health Insurance Portability and Accountability Act
B) Health Inspection Portability and Accountability Act
C) Heath Insurance Preferentially and Accountability Act
D) Health Inspection Preferentially and Accountability Act

Question 14

One concern that the Health Care Quality Improvement Act (HCQIA)addressed was the weaknesses in existing peer ____________________ processes.

Question 15

The ____ stores information regarding physicians' and dentists' professional competence and conduct.

A) National Practitioner Data Bank (NPDB)
B) Network of Competencies Data Bank (NCDB)
C) National Record of Health Care Provider Competencies (NRHCPC)
D) Network of Known Practitioner Errors (NKPE)

Question 16

An example of an agency within the Department of Health and Human Services is the ____.

A) National Institutes of Health (NIH)
B) National Physicians Institute (NPI)
C) Committee for Health and Cooperation (CHC)
D) Center for Family Medicine (CFM)

Question 17

The U.S.health care industry comprises a relatively large number of organizations that are ____________________ from paying most if not all taxes including income,property,and sales taxes.

Question 18

____________________ serves as a primary mechanism by which states regulate the quality of care provided by health care organizations.

Question 19

One challenge that the Food and Drug Administration (FDA)faces is to balance the public demand for speedy access to newly developed drugs against the ____ that might accompany an accelerated approval process.

A) excitement
B) rewards
C) risks
D) failures

Question 20

The purpose of the ___________________ laws is to promote competition based on the conviction that competitive markets bring benefits of relatively lower consumer prices,higher output,and greater innovation.

Question 21

Match each item with a statement below:

Determines the process of promulgating regulations

A)Sherman Act
B)Administrative Procedures Act
C)False Claims Act (FCA)
D)Department of Health and Human Services (HHS)
E)Stark Physician Self-Referral Law (Stark)
F)Prospective Payment System (PPS)
G)Anti-Kickback Statute (AKS)
H)Medicaid
I)Clayton Act
J)Food and Drug Administration

Question 22

Match each item with a statement below:

Prohibits the knowing and willful solicitation or receipt of remuneration by any person in connection with items or services for which payment could be made by Medicare or Medicaid

A)Sherman Act
B)Administrative Procedures Act
C)False Claims Act (FCA)
D)Department of Health and Human Services (HHS)
E)Stark Physician Self-Referral Law (Stark)
F)Prospective Payment System (PPS)
G)Anti-Kickback Statute (AKS)
H)Medicaid
I)Clayton Act
J)Food and Drug Administration

Question 23

Match each item with a statement below:

Fixed payment system for inpatient services based on a patient's specific diagnosis within Medicare system

A)Sherman Act
B)Administrative Procedures Act
C)False Claims Act (FCA)
D)Department of Health and Human Services (HHS)
E)Stark Physician Self-Referral Law (Stark)
F)Prospective Payment System (PPS)
G)Anti-Kickback Statute (AKS)
H)Medicaid
I)Clayton Act
J)Food and Drug Administration

Question 24

Match each item with a statement below:

Principal federal government agency for health care

A)Sherman Act
B)Administrative Procedures Act
C)False Claims Act (FCA)
D)Department of Health and Human Services (HHS)
E)Stark Physician Self-Referral Law (Stark)
F)Prospective Payment System (PPS)
G)Anti-Kickback Statute (AKS)
H)Medicaid
I)Clayton Act
J)Food and Drug Administration

Question 25

Match each item with a statement below:

Combined federal and state program that provides medical assistance to low-income individuals and families

A)Sherman Act
B)Administrative Procedures Act
C)False Claims Act (FCA)
D)Department of Health and Human Services (HHS)
E)Stark Physician Self-Referral Law (Stark)
F)Prospective Payment System (PPS)
G)Anti-Kickback Statute (AKS)
H)Medicaid
I)Clayton Act
J)Food and Drug Administration

Question 26

Match each item with a statement below:

Prohibits knowingly submitting or causing to be submitted a false claim to the government

A)Sherman Act
B)Administrative Procedures Act
C)False Claims Act (FCA)
D)Department of Health and Human Services (HHS)
E)Stark Physician Self-Referral Law (Stark)
F)Prospective Payment System (PPS)
G)Anti-Kickback Statute (AKS)
H)Medicaid
I)Clayton Act
J)Food and Drug Administration

Question 27

Match each item with a statement below:

Prohibits contracts and other agreements that unreasonably restrain trade

A)Sherman Act
B)Administrative Procedures Act
C)False Claims Act (FCA)
D)Department of Health and Human Services (HHS)
E)Stark Physician Self-Referral Law (Stark)
F)Prospective Payment System (PPS)
G)Anti-Kickback Statute (AKS)
H)Medicaid
I)Clayton Act
J)Food and Drug Administration

Question 28

Match each item with a statement below:

Prohibits physicians from referring patients to certain health services providers with which the physicians have a financial relationship

A)Sherman Act
B)Administrative Procedures Act
C)False Claims Act (FCA)
D)Department of Health and Human Services (HHS)
E)Stark Physician Self-Referral Law (Stark)
F)Prospective Payment System (PPS)
G)Anti-Kickback Statute (AKS)
H)Medicaid
I)Clayton Act
J)Food and Drug Administration

Question 29

Match each item with a statement below:

Prohibits mergers,acquisitions,and joint ventures that threaten to substantially lessen competition or are likely to create a monopoly

A)Sherman Act
B)Administrative Procedures Act
C)False Claims Act (FCA)
D)Department of Health and Human Services (HHS)
E)Stark Physician Self-Referral Law (Stark)
F)Prospective Payment System (PPS)
G)Anti-Kickback Statute (AKS)
H)Medicaid
I)Clayton Act
J)Food and Drug Administration

Question 30

Match each item with a statement below:

Exercises influence through regulatory efforts to ensure the safety and efficacy of drugs and medical devices

A)Sherman Act
B)Administrative Procedures Act
C)False Claims Act (FCA)
D)Department of Health and Human Services (HHS)
E)Stark Physician Self-Referral Law (Stark)
F)Prospective Payment System (PPS)
G)Anti-Kickback Statute (AKS)
H)Medicaid
I)Clayton Act
J)Food and Drug Administration