Chap. 06 Questions
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Legal Aspects of Fire Protection
Chapter 6 Assignment
1. What are the provisions of the HIPAA Privacy Rule and to whom does it apply?
The HIPAA Privacy Rule addresses use and disclosure of individuals’ health information by covered entities. It establishes standards for individuals’ privacy rights and aims to permit use of private health information while protecting privacy of people.
The HIPAA Privacy Rule applies to health plans, health-care clearinghouses, and
any health-care provider who transmits health information in electronic form. It also defines a category of business associates that are not covered entities on their own or provide services for a covered entity that involve the use or disclosure of individually identifiable health information.
2. List the circumstances under which disclosure of protected health information is allowed by HIPAA.
1. To the individual
2. For treatment, payment, or health-care operations
3. To other parties as permitted by the individual
4. Incidental use and disclosure rule
5. Public interest and benefit activities:
a. Required by law
b. Public health activities
c. Victims of abuse, neglect, or domestic violence
d. Health oversight activities
e. Judicial and administrative proceedings
f. Law enforcement purposes
g. Decedents
h. Cadaveric organ, eye, or tissue donation
i. Research
j. Serious threat to health or safety
k. Essential governmental functions
l. Worker’s compensation
6. Limited data set
3. Describe patient–physician privilege.
Statements made to physicians by patients for the purposes of treatment cannot be introduced into evidence in legal proceedings. In many instances, those communications are not discoverable either, meaning a plaintiff cannot obtain them through subpoena or other methods to use in a lawsuit against the defendant. Some states consider EMT to be an extension of the physician.
4. What are advanced directives? Describe three types of advanced directives.
Advanced directives are legal documents that convey the medical wishes of a specific person in the event of incapacity or an inability to communicate.
1. Living will – tells healthcare providers what type of care a person wants is he or she is ever unable to share his or her desires due to incapacity.
2. Power of attorney – gives someone else the ability to make healthcare decisions for the person who executed the document.
3. Do not resuscitate – orders that state common resuscitative measures, such as CPR, intubation, and other invasive techniques are prohibited one
the patient reaches their end of life.
5. Describe various ambulance service levels covered by Medicare.
1. Basic Life Support (BLS) (emergency and nonemergency)
2. Advanced Life Support, Level 1 (ALS1) (emergency and nonemergency)
3. Advanced Life Support, Level 2 (ALS2)
4. Paramedic ALS intercept (PI)
5. Specialty care transport (SCT)
6. Fixed-wing transportation (FW)
7. Rotary-wing transport (RW)
6. Describe provisions of the Anti-Kickback Statute of 1972.
The federal Anti-Kickback Statute makes it a crime to “knowingly and willfully make or cause to be made any false statement or representation of a material fact in any application for any benefit or payment under a Federal health care program.” Any knowing and willful solicitation or receipt of any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind, in return for referring an individual to a person or service receiving federal health-care program money, or for purchasing, leasing, or ordering of any good, facility, service, or item for which payment may be made in whole or in part under a federal health-care program, is considered a federal felony.
7. What is whistleblower protection?
The False Claims Act contains language (under Section 3730(h)) that protects employees, contractors or agents, who report wrongdoing under this act against discharge, demotion, suspension, threats, harassment, or other discrimination related to the terms and conditions of employment.
8. Describe provisions and potential violations of EMTALA?
EMTALA was intended to combat the growing problem of “patient dumping,” in which hospitals transferred patient to other facilities (without properly stabilizing them) or simply refused to treat them because they were unable to pay. If a patient “comes to [a] hospital emergency department” requesting “examination or
treatment for a medical condition,” the hospital must provide an appropriate medical screening examination to determine whether an emergency medical condition exists. If it does, the hospital must stabilize the patient’s medical condition before transferring or discharging the patient.
EMTALA violations:
1. If a hospital diverts a nonhospital-owned ambulance to another hospital without being on formal diversionary status.
2. If a hospital delays the receipt of a patient from the EMS crew to avoid obligation to assess patient under EMTALA.
9. Describe CSA regulations for the disposal of controlled substances.
If a controlled substance is expired or otherwise needs to be removed from inventory, the EMT or staff cannot simply throw it away. CSA regulations state that the registrant should contact the Special Agent in Charge of the DEA in the area in which the registrant is located and request authority and instructions to dispose of such substances. The Special Agent in Charge may authorize and instruct disposal in one of the following manners:
1. Transfer to an individual who is registered under the CSA and authorized to process the substance.
2. Delivery to an agent of the DEA or to the nearest DEA office.
3. Destruction in the presence of an agent of the DEA or other authorized person.
4. Disposal by other means determined by the Special Agent in Charge to ensure the substance does not become available to unauthorized persons.
If a registrant is required to dispose of controlled substances on a regular basis, the Special Agent in Charge may authorize the registrant to dispose of such substances without prior approval of DEA in each instance. In such a case, the registrant must keep records of such disposals and file periodic reports with the Special Agent in Charge.
10 What is the goal of CLIA and how does it impact EMS operations?
In 1988, Congress passed the Clinical Laboratory Improvement Amendments (CLIA) to establish quality standards for all laboratory testing. The goal of this
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legislation was to ensure the accuracy, reliability, and timeliness of patient test results regardless of where the test was performed. This has an impact on EMS operations because ambulances may be defined as laboratories.