RHIA EXAM PREP DOMAIN 1.1
QUESTIONS AND ANSWERS
Office of Inspector General (OIG) - ANSWER-Responsibility of conducting and
monitoring audits, inspections, and investigations regarding programs or projects
sponsored by DHHS
Agency for Healthcare Research & Quality (AHRQ) - ANSWER-Primary focus is to
produce and disseminate scientific and policy-relevant information that improves quality,
reduces cost, and enhances effectiveness of health care
Centers for Disease Control & Prevention (CDC - ANSWER-Concerned with
communicable disease, environmental health, and foreign quarantine activities
Food & Drug Administration (FDA) - ANSWER-Responsible for the safety of foods,
drugs, medical devices, cosmetics, and radiation-emitting equipment
National Institutes of Health (NIH) - ANSWER-Major medical research center composed
of numerous institutes and centers
To be eligible for Medicare & Medicaid reimbursement, providers must demonstrate
compliance with the - ANSWER-Conditions of Participation (COP)
those accredited are said to have (accredited facility meets requirements for Medicare
COP) - ANSWER-deemed status
Occupational Safety and Health Administration (OSHA) - ANSWER--Mandates
employers provide a safe and healthy work environment
-Responsible for developing standards and regulations conducting inspections and
investigations to determine compliance, and it proposes corrective actions for
noncompliance in matters related to occupational safety and health
Licensure - ANSWER--gives legal approval for a facility to operate or for a person to
practice within his or her profession
Emergency Medical Treatment and Labor Act (EMTALA) - ANSWER--Law requires
every patient, regardless of ability to pay, who arrives at an emergency department (ED)
with an emergency medical condition, including active labor, be provided a medical
screening examination and stabilizing medical care
-If facility is unable to provide stabilizing treatment or if the patient requests, a transfer to
an appropriate facility should be made
,Patient Self-Determination Act of 1990 - ANSWER-Intended to increase public's
awareness of respective state laws governing patient options for health care, patient
rights, and advance directives
advance directive - ANSWER-legal, written document that specifies patient preferences
regarding future health care or specifies another person to make medical decisions in
the event the patient has an incurable or irreversible condition and is unable to
communicate his or her wishes
Health Insurance Portability and Accountability Act (HIPAA) - ANSWER--
Comprehensive law dealing with a variety of health care issues mainly directed at
improving access, affordability, and adequacy of health insurance
-Provide for portability of group health insurance when a person changes employers
Accreditation - ANSWER--Process by which a private nongovernmental organization of
agency performs an external review and grants recognition to a program of study or
institution that meets certain predetermined standards
-Accreditation is voluntary
-Financial and legal incentives exist
The Joint Commission (TJC) - ANSWER-Private, nonprofit organization that establishes
guidelines and standards for the operation and management o health care facilities with
emphasis on health care functions crucial to patient care
Commission on Accreditation of Rehabilitation Facilities (CARF) - ANSWER-
Independent accrediting agency for rehabilitation facilities
Rehabilitation - ANSWER-the processes of treatment and education that leads the
disabled person to the achievement of maximum independence and function and a
personal sense of well-being
Constitutional law - ANSWER-highest law in the land - takes precedence over
constitutions and laws in individual states and local jurisdictions
Common law - ANSWER-Unwritten law originating from court decisions where no
applicable statue exists
Precedent - ANSWER-binding force for future cases addressing same issues in that
state
Stare decisis - ANSWER-"let the decision stand"
Statutory law - ANSWER-Written law established by federal and state legislatures
, Administrative law - ANSWER-Branch of law that controls government's agency, or
administrative operations
State and Federal Court - ANSWER-Trial, Appellate, Supreme
Public Law - ANSWER-oRelationship between the government and individuals or
organizations
oThe government (any level) is a party
oCriminal law
oStatutory and administrative law
Private Law - ANSWER-oRelationship between private entities or individuals
oThe government is not a party
oOften includes torts, contracts, and property issues
Civil Law - ANSWER-oInvolves relationships between individuals, corporations,
government entities, and other organizations
oMost actions encountered in healthcare industry are based on civil law
oRemedy for civil wrong is monetary but may include carrying out or stopping some
action
Depositions - ANSWER-sworn statements
Interrogatories - ANSWER-formal questions
Request for production - ANSWER-legal request for documents from opposing parties
Subpoenas - ANSWER-discovery may be initiated by subpoenas. Directives to attend or
respond to legal proceedings
Tort - ANSWER-oWrongful conduct that causes harm (civil)
oConduct outside the standard of care
Negligent Torts (negligence) - ANSWER-Results when a person does not act the way a
reasonably prudent person would act under the same circumstances
Standard of Care - ANSWER-what an individual is expected to do or not do in a given
situation
Malfeasance - ANSWER-execution of an unlawful or improper act (judge excepts bribe)
Misfeasance - ANSWER-improper performance of an act resulting in injury to another
(nurse perform cpr and break a rib/ leave sponge in patient during surgery)
QUESTIONS AND ANSWERS
Office of Inspector General (OIG) - ANSWER-Responsibility of conducting and
monitoring audits, inspections, and investigations regarding programs or projects
sponsored by DHHS
Agency for Healthcare Research & Quality (AHRQ) - ANSWER-Primary focus is to
produce and disseminate scientific and policy-relevant information that improves quality,
reduces cost, and enhances effectiveness of health care
Centers for Disease Control & Prevention (CDC - ANSWER-Concerned with
communicable disease, environmental health, and foreign quarantine activities
Food & Drug Administration (FDA) - ANSWER-Responsible for the safety of foods,
drugs, medical devices, cosmetics, and radiation-emitting equipment
National Institutes of Health (NIH) - ANSWER-Major medical research center composed
of numerous institutes and centers
To be eligible for Medicare & Medicaid reimbursement, providers must demonstrate
compliance with the - ANSWER-Conditions of Participation (COP)
those accredited are said to have (accredited facility meets requirements for Medicare
COP) - ANSWER-deemed status
Occupational Safety and Health Administration (OSHA) - ANSWER--Mandates
employers provide a safe and healthy work environment
-Responsible for developing standards and regulations conducting inspections and
investigations to determine compliance, and it proposes corrective actions for
noncompliance in matters related to occupational safety and health
Licensure - ANSWER--gives legal approval for a facility to operate or for a person to
practice within his or her profession
Emergency Medical Treatment and Labor Act (EMTALA) - ANSWER--Law requires
every patient, regardless of ability to pay, who arrives at an emergency department (ED)
with an emergency medical condition, including active labor, be provided a medical
screening examination and stabilizing medical care
-If facility is unable to provide stabilizing treatment or if the patient requests, a transfer to
an appropriate facility should be made
,Patient Self-Determination Act of 1990 - ANSWER-Intended to increase public's
awareness of respective state laws governing patient options for health care, patient
rights, and advance directives
advance directive - ANSWER-legal, written document that specifies patient preferences
regarding future health care or specifies another person to make medical decisions in
the event the patient has an incurable or irreversible condition and is unable to
communicate his or her wishes
Health Insurance Portability and Accountability Act (HIPAA) - ANSWER--
Comprehensive law dealing with a variety of health care issues mainly directed at
improving access, affordability, and adequacy of health insurance
-Provide for portability of group health insurance when a person changes employers
Accreditation - ANSWER--Process by which a private nongovernmental organization of
agency performs an external review and grants recognition to a program of study or
institution that meets certain predetermined standards
-Accreditation is voluntary
-Financial and legal incentives exist
The Joint Commission (TJC) - ANSWER-Private, nonprofit organization that establishes
guidelines and standards for the operation and management o health care facilities with
emphasis on health care functions crucial to patient care
Commission on Accreditation of Rehabilitation Facilities (CARF) - ANSWER-
Independent accrediting agency for rehabilitation facilities
Rehabilitation - ANSWER-the processes of treatment and education that leads the
disabled person to the achievement of maximum independence and function and a
personal sense of well-being
Constitutional law - ANSWER-highest law in the land - takes precedence over
constitutions and laws in individual states and local jurisdictions
Common law - ANSWER-Unwritten law originating from court decisions where no
applicable statue exists
Precedent - ANSWER-binding force for future cases addressing same issues in that
state
Stare decisis - ANSWER-"let the decision stand"
Statutory law - ANSWER-Written law established by federal and state legislatures
, Administrative law - ANSWER-Branch of law that controls government's agency, or
administrative operations
State and Federal Court - ANSWER-Trial, Appellate, Supreme
Public Law - ANSWER-oRelationship between the government and individuals or
organizations
oThe government (any level) is a party
oCriminal law
oStatutory and administrative law
Private Law - ANSWER-oRelationship between private entities or individuals
oThe government is not a party
oOften includes torts, contracts, and property issues
Civil Law - ANSWER-oInvolves relationships between individuals, corporations,
government entities, and other organizations
oMost actions encountered in healthcare industry are based on civil law
oRemedy for civil wrong is monetary but may include carrying out or stopping some
action
Depositions - ANSWER-sworn statements
Interrogatories - ANSWER-formal questions
Request for production - ANSWER-legal request for documents from opposing parties
Subpoenas - ANSWER-discovery may be initiated by subpoenas. Directives to attend or
respond to legal proceedings
Tort - ANSWER-oWrongful conduct that causes harm (civil)
oConduct outside the standard of care
Negligent Torts (negligence) - ANSWER-Results when a person does not act the way a
reasonably prudent person would act under the same circumstances
Standard of Care - ANSWER-what an individual is expected to do or not do in a given
situation
Malfeasance - ANSWER-execution of an unlawful or improper act (judge excepts bribe)
Misfeasance - ANSWER-improper performance of an act resulting in injury to another
(nurse perform cpr and break a rib/ leave sponge in patient during surgery)
