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HIPS
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Privacy
Issues for Clinicians > Quiz + Answers
How to
take this course
 The
questions, answers and explanations are provided below. If
you disagree with our answer, or have additional questions,
please send email to pdpp@miami.edu.
Include the text of the quiz question(s) with which you disagree
in your correspondence.
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1. Which of the
following is true?
A.
Federal regulations (under HIPAA) require separate, independent
consent or authorization for treatment-related uses and disclosures.
B. Federal
regulations include treatment-related uses and disclosures
in a large category (along with payment and health care operations)
that require no specific permission from patients.
C. State laws and regulations regarding treatment-related
consent are all over-ridden by HIPAA, and no longer have any
effect.
D. State laws and regulations always over-ride federal regulations
for treatment-related consent.
B is correct. State laws and regulation over-ride
(pre-empt) federal requirements only when they are stricter.
•
• • • •
2. Which of the following statements about
the "minimum necessary standard" is true?
A. The federal "minimum necessary" standard for
information use and disclosure applies to treatment with the
same force that it applies to everything else.
B. The
standard doesn't apply to treatment-related uses and disclosures
at all. It's completely waived.
C.
The standard applies to treatment-related uses, but not treatment-related
disclosures, so as to avoid any interference with information
exchanges among practitioners.
D. It's over-ridden
by any conflicting state laws and regulations.
C, the
most complex answer, is also the correct one. If this distinction
is confusing -- and we can see why it might be -- just think
of "minimum necessary" as applying to clinical settings
across-the-board, but in a particularly light way. Stricter
state restrictions are not over-ridden.
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• • • •
3. The
federal (HIPAA) provision for "incidental uses and disclosures"
means what?
A. Accidental
uses and disclosures are never subject to penalties in treatment
contexts, even if there is negligence.
B.
Accidental uses and disclosures are not subject to penalties
provided reasonable administrative, physical and technical
safeguards are in place.
C. Accidental
uses and disclosures are not subject to penalties provided
reasonable safeguards are in place and there has been no negligence.
D. It's over-ridden
by any conflicting state laws and regulations.
C, the most complex answer, is again the correct
one.
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• • • •
4. Patients
must be provided with federally-mandated Privacy Notices when
they first encounter direct treatment providers.
The implications of that for clinicians are:
A.
Clinicians have no obligations to discuss privacy issues with
patients. That task is generally reserved for the organization's
"privacy official."
B. Clicians are
forbidden from discussing privacy questions with patients.
That task may only be undertaken by a privay official or an
appropriate-certified alternate.
C.
Clinicians are obligated to be the primary resource for patients'
privacy questions, including questions about the exercise
of federal rights.
D. The
provision of the Notice just before receiving treatment means
clinicians will receive some questions about privacy issues.
There is an obligation to know the answers, or to be able
to direct the patient to someone who does.
D is correct. Are you getting the sense that the
longest answer is always the correct one?
•
• • • •
5. What
best describes the role of the clinician in these matters?
A. Clinicians
have a primary responsibility to deliver care, so they aren't
expected to be role-models for information privacy and security
issues.
B. How
clinicians handle information inevitably sets the tone for
everyone else, so they example they set is critical.
B is correct. We figured you deserved an easy one.
•
• • • •
6.
“Psychotherapy notes” is one category of health
information for which HIPAA currently extends “extra”
protections, with a requirement for separate authorization.
For which other category does HIPAA make special provisions?
A.
genetic information.
B.
pregnancy-related information.
C.
AIDS and sexually-transmitted disease information.
D.
None of the above.
D
is correct. So far. This is in marked contrast to state statutes,
which typically carve out exceptions and special requirements
for all of these categories.
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• • • •
7.
When a patient enters a clinical facility, they must inevitably
surrender control of their information for a broad range of
uses and disclosures. In the circumstances where the patient
retains control of information, which of the following is
true?
A.
If the person controls a decision about treatment, he/she
generally controls decisions about the information associated
with it.
B.
Where the patient is too young or too incapacitated, the clinician
may designate a personal representative to make information
decisions on his/her behalf.
C.
Discussions with patients' families now require explicit written
permission from the patient, or his/her personal representative.
D.
All of these are true.
A
is correct. Physicians do not designate personal respresentatives.
Discussions with family members require only oral agreement,
though some facilities may opt for a written document anyway.
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• • • •
8. HIPAA provides for various rights with respect
to patients’ health records. Which of these is not
a HIPAA right?
A. To access and obtain a copy of the entire
medical record without exception.
B. To secure changes to any element of the record
that the patient believes to be in error.
C. To obtain an accounting of all disclosures
of that record, regardless of type.
D. None of these are HIPAA rights.
D is correct, and apologies for the
trickery. Patients can obtain a copy of most, but not always
all, of a their records (e.g., psychotherapy notes). Changes
need not be made if the providers believe the information
is correct (patients can then have an "exception"
included in the record). Many types of disclosures don't require
an accounting -- e.g., those for treatment, payment and health
care operations.
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