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Can a patient successfully sue a doctor if there is no physician-patient relationship? - ansNo If there is no prior physician-patient relationship, are you legally obliged to respond to a call from a patient for treatment? - ansNo Does being on call give rise to a physician-patient relationship? - ansNo How can one terminate a physician-patient relationship, without abandonment if there is ongoing treatment? - ans30 days written notice; must provide for emergency Does a physician's duty extend to the unborn child or potential victims of an ill patient? - ansYes What is "proximate cause"? - ansProve that negligence caused harm and that the cause was not too remote; what is required to hold a defendant liable in a civil lawsuit What are the two components of proximate cause? - ansCause-in-fact (but-for test) and foreseeability Does an expert witness have to be actively practicing medicine? - ansYes Does an expert witness have to know standards of care? - ansYes Does an expert witness have to have enough training to express an opinion on whether standard of care was provided? - ansYes Does an expert witness have to be board certified? - ansNo, board certified or eqivalent In a medical malpractice case, are expert witnesses required? - ansYes, with two exceptions In a medical malpractice setting, what 2 instances do not need expert testimony? - ansRes ipsa loquitur (e.g., amputation of wrong leg) and negligence per se (a law was broken) What are "exemplary damages"? - ansDamages above compensatory designed to punish the defendant and deter the behavior Is there a cap to noneconomic damages? How much? - ans$250,000 for physicians, $500, for hospitals Does the cap on noneconomic damage depend on the number of defendants or claimants? - ansNo What is "proportional responsibility"? - ansPercentage of liability apportioned according to percentage of fault Can the claimant have part of the proportional responsibility? - ansYes If the claimant's proportionate responsibility is more than what %, he/she may not recover damages? - ansIf > 50%, no damages awarded How long is the statute of limitations for adults? For minors? - ans2 years; for minors 2 years after becoming 18 years of age By how much can the statute of limitations be extended and how? - ansFile complaint—extra 60 - day, notice letter extends statute by 75 days What is the statute of limitations for wrongful death? - ans2 years What is the discovery rule? Give examples. - ansStatute does not begin until damage is discovered. For example, a retained sponge that is found 3 years post-op Is there immunity from civil action in emergency cases? - ansYes, except gross negligence Is there immunity from civil action in volunteer care? - ansYes, except gross negligence When can a physician be charged with "assault and battery"? - ansUn-consented surgery or examination or when exceeding the scope of the consent
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When can a physician be charged with patient abandonment? - ansUnilateral cessation of treatment when continued treatment is necessary What is "strict liability"? - ansLiability that does not depend on actual negligence, but that is based on a breach of a duty to make something safe. This often applies to product liability Are hospitals liable for the actions of a physician? - ansNo, unless the hospital employs the physician Who determines in a criminal case if the medical records of a patient should be released? - ansJudge by inspection How many days do you have to release medical records to an attorney? - ans45 days Can medical records be admitted as evidence in court? What are the requirements? - ansYes, but only with affidavit What are schedule 1, 2, 3, 4, 5 drugs? - ansSchedule 1—no known use (e.g., heroin); schedule 2—very addictive (morphine, cocaine); schedule 3- 5 —less addictive What are dangerous drugs? - ansPrescription drugs other than schedule 1- 5 How many DEA registrations do you need if you prescribe drugs? dispense drugs? - ansOne to prescribe; a separate registration for each location where you dispense How often do you renew your DEA license? - ansEvery 3 years Can you move your office location and then change your DEA? - ansNo, need to change BEFORE move Is a DEA registration sufficient to prescribe drugs in Texas? - ansNo, also need Department of Public Safety Bureau of Narcotics and Dangerous Drug registration How often do you renew a DPS license? - ansYearly Do you have to display the DEA and DPS licenses? - ansNot required by any statute. How many days do you have to notify the DPS of any change in your information (name, address, tel., etc.)? - ans7 days Can you have your DPS suspended and keep your DEA or vice versa? - ansNo, they are interconnected For schedules 2-5 drugs, can you just put the number of pills on prescription? - ansNo, number and number spelled out Do you have to put intended use on prescription? - ansYes With how many days of a schedule 2-5 drug can a patient be discharged from the hospital? - ans7 days; only if the drug was already rx in the hospital What kind of prescription pad do you need for schedule 2 drugs? Can you use stickers? - ansOfficial DPS form; no stickers Can a physician prescribe schedule 2 over the phone? - ansYes, for emergencies, and only for the duration of emergency How many days does the physician have to mail the schedule's emergency prescription to the pharmacy? - ans7 days How many days does the patient have to fill schedule 2 prescriptions? - ans7 days Can you refill a schedule 2 prescription? How about schedule 3-5? - ansNo for schedule 2. Max 5 refills for schedules 3-5. Who can call in prescription from a physician's office? - ansAny qualified DESIGNATED person
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Does the physician confidentiality apply to court or administrative proceedings brought by the patient against a physician? - ansNo Can the physician violate confidentiality if he/she thinks he or someone else is in danger? - ansYes, must report that to law enforcement agency (NOT for mental health) What information must a release of medical records include? - ansType of records, reason, and person to whom to release How many days (hospital) or business days (physician) does a hospital/physician have to provide medical records when they are requested? - ansPhysician has 15 business days, hospital has 15 days What is "therapeutic privilege," when can it be used, who has access to the information, and what is the protocol the physician must follow? - ansIf physician thinks that information would be harmful to the patient, it can be withheld; in writing, copy in the chart; films or tests must be released to patient representative Can the physician charge for medical records and films? For an affidavit? Does he have to give the information if the patient does not pay? What does he do if the patient does not pay?
- ansYes, can charge $25 for first 20 pages, then 15¢ per page plus postage; notarization $15, films $8; patient MUST pay to get records, 10-day notice Can you charge a patient requesting records in order to apply for disability or public aid? How many copies are patients entitled to? Can you charge if federal agency is requesting records? - ansNo; one copy; no How many years does a physician MD have to keep records for adults? for minors? How many years do hospitals have to keep records for adults? For minors? - ans7 years for adults, 7 years or until age 21; hospital 10 years Can a physician or hospital get rid of records after the required years if these records might be part of a litigation? - ansNo Can you relate information without patient consent for treatment? Billing? To report abuse? To law enforcement? For funeral directions? For worker's comp? - ansYes, all of the above What is the "minimum necessary standard" for a medical release? - ansIt protects health care information unless it is required to be released (investigation, law enforcement, authorized release, participating care providers, HIPAA compliant release) Does a patient have the right to see his/her own record? Can he/she ask for amendments to the records? - ansYes; yes, they can request amendments What is the Texas medical record privacy act? Is it like HIPAA? - ansIt is the state equivalent of HIPAA Within how many days must a hospital send an itemized bill to patients? Is this mandatory? Or done by request? When must the hospital inform patients of this option? - ansUpon request, within 30 business days; hospital must inform patient of availability of itemized bill Can medical records be obtained with a subpoena? Does this include substance-abuse records? - ansYes; no Are substance abuse records admissible during criminal proceedings? - ansNo, unless the crime is EXTREMELY serious Is HIV information confidential? - ansYes
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Can you "break" confidentiality in order to tell a spouse that his/her spouse is HIV positive? - ansYes Can you break confidentiality to tell a partner about notification program?. - ansYes Are blood bank records confidential? - ansYes If a blood bank finds a donor with an infectious disease, can they call other blood banks and tell them the name of donor and the disease?Edition. - ansThey can tell name of donor, NOT disease If a blood bank finds that blood outbound to hospitals is HIV positive, can they call the hospitals and give name of donor? Type of disease? - ansThey can tell name of disease, NOT donor For statistical purposes, can a blood bank give out medical records? Names? - ansYes, but not names or other identifying information Is genetic information confidential? - ansYes Can patients have access to the results of their genetic testing? - ansYes What kind of crime is the unauthorized release of records? - ansMisdemeanor Can the Texas Medical Board (TMB) show preference to a specific school of medicine such as medicine v. osteopathy? - ansNo What does the Medical Practice Act (MPA) regulate? - ansThe practice of medicine Who does the MPA apply to? - ansPhysicians (MD, DO), PAs, and acupuncturists Does the MPA apply to the armed forces and federal public health? Can they moonlight? - ansIt does NOT apply to a federal job, they can NOT moonlight outside the federal setting Does the MPA apply to emergency assistance if there is NO charge of money? If there is money charged or billed? - ansNO if no charge; YES if money is charged Are medical students in "board-approved schools" subject to the MPA? - ansNo Does the MPA prohibit self-care? - ansNo Does the MPA apply to physicians in contiguous states? - ansNO (physicians from nearby states can only order care for patients in hospice or nursing homes) How many people are on the TMB? Who appoints them? Who must confirm them? - ans members, appointed by the governor, confirmed by the senate Can the board subpoena people and records? Who can serve a subpoena? - ansYES, subpoenas can be served by board investigator or sent by certified mail How often does the Department of Public Safety (DPS; state police) check on physicians and report to the board? - ansQuarterly What are acceptable methods to tell the public on how to register a complaint to the TMB? In what languages? Where can a physician include this info? - ansBy phone (direct number and 1 - 800 number) or by mail; posted sign, on registration forms or bill; in English and Spanish How often must the TMB disseminate updated information? What info is included? - ans times per year; info includes disciplinary action, board activities and functions, changes to the MPA and attorney general opinions Are disciplinary orders private or public? - ansPublic Are the following included in the physician profile?
- ethnic origin
- CME
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If you practice pain management, how many CMEs in pain management are required? - ansNone, but they are recommended Who can initiate a complaint to the board? - ansAnyone What is the "health professions council"? - ansCouncil of various professionals that establishes a central telephone complaint system (800-number) Does the TMB have to notify a physician when a complaint is filed? Are there exceptions? How often do the parties get updated on proceedings? - ansYes, within 30 days, except if it would interfere with the investigation; updates are quarterly When does the TMB release complaint information to the hospital? - ansUpon written request Who investigates issues of "medical competency"? - ansAn expert physician panel appointed by the board consisting of physicians ONLY What do medical malpractice carriers have to report to the TMB regarding malpractice? Within what time limit? Who punishes them if they do not report? What does a physician without insurance have to report and when? Is there a difference for NPDB/HCQIA? - ansWithin 30 days from a complaint being filed in a lawsuit, settlement; noninsured MDs have to self-report within 30 days; any payment must be reported to NPDB by HCQIA requirements Restrictive action by the TMB: Within what time limit must the board tell the hospital? Tell Medicare? Tell the secretary of health & professional societies & complainant? - ansNext working day for hospitals; in writing for all within 30 days. Restrictive action by the TMB: How often must the board make public notices about disciplinary orders? - ans2 times per year. Restrictive action by the TMB: Must the board report crimes found during investigations? - ansYes, to the law enforcement. Restrictive action by the TMB: Within how many days must the board report to the NPDB? - ans30 days. Restrictive action by the TMB: Within how many days must a court report to the board about convictions, felonies, and misdemeanors and addiction issues be filed? - ans30 days. Are TMB reports confidential? - ansYes Who can the NPDB give info to? How about to patients? How about statistical data? - ansHospitals, self-requesting physicians, board, other state or federal agencies, attorneys; for statistical purposes if no identity disclosed When is it not illegal to perform a third-trimester abortion? - ansTo prevent mother's death, if unborn has severe irreversible brain damage When is it not illegal to perform an abortion on a minor? - ansIn emergency and with court order Is sexual contact between a physician and patient OK if the patient consents? - ansNO, the disparity of power does not allow consent Why is it unprofessional to initially prescribe drugs over the Internet? - ansDid not verify identity of patient, no physician coverage or follow-up guaranteed How can you terminate care to a patient? - ans30 day notice, certified letter, available for emergencies during that time, give alternative physicians
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What prescriptions does a physician need to keep records on? Dangerous drugs? Controlled substances? Samples? - ansSamples and dangerous drugs as part of medical record; for schedule 3-5 records and log; for schedule 2 separate log and records; keep record for 2 years; do inventory on schedule drugs every 2 years Can the board administer monetary penalties? - ansYes What happens to his/her license if a physician goes to prison? - ansTMB is required to suspend How many malpractice claims within what time period automatically open a board investigation? - ans3 within 5 years How many people from the TMB are necessary to temporarily suspend a license? - ansPresident appoints a 3-member panel; can be done by phone Is self-reporting addiction a disciplinary action? Is a rehabilitation order a disciplinary order?
- ansNo; no, it is the only nondisciplinary order Is probation a disciplinary order? Who cannot be put on probation? - ansYes; sex offenders, felons, prisoners, or if the physician is a threat to public Can the TMB make a physician give a refund? What is the maximum amount of refund? - ansYes; cannot be more than the amount paid What is monitoring? - ansContinued oversight of the board for subjects on disciplinary orders Who is part of an informal hearing and what is it? - ansMembers of the board, at least one of whom is a public member, physician, his/her attorney; a means to settle a case without an administrative hearing When do you go to formal hearings? What is the SOAH? Is it part of the TMB? Who holds the hearings? Who is participating? Must the TMB follow the ruling of the administrative law judge? - ansIf no settlement reached after informal hearing; state office of administrative hearing; no; board members, physician, attorneys, and administrative law judge; NO, they do not have to follow the judge's ruling Where can a physician file an appeal? Within what time period? Can he practice in the interim? - ansCircuit court Travis county, within 30 days after final board decision; physician cannot practice in interim Can the TMB panel serve a subpoena to a physician? - ansYes Can the physician get his file? - ansYes, with written request, within 30 days Can you voluntarily surrender your license? - ansYes, but board does not have to accept it If you surrender your license to avoid disciplinary action, can you reapply for it? - ansYes, if there is no prohibitive circumstance If you surrender your license voluntarily, whose burden is it to show competence if you want it back? - ansThe physician who surrendered the license How often and how soon can you reapply to have your license reinstated if it has been canceled/suspended, etc.? - ansOnce a year What is the maximum administrative penalty? How long do you have to pay it? - ans$ per violation; 30 days What is the maximum penalty for an action for civil penalty by the attorney general? How long do you have to pay it? - ans$1000 per penalty, 30 days
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What is the difference between a partnership and a limited liability partnership? - ansThe limited liability partnership can limit individual liability white partner A is liable for the acts of partner B Who can incorporate in Texas? Can physicians practice through corporations? - ansDentists, PT but NOT MD; MD cannot practice through corporation Are there any corporations that can employ physicians? - ansYes, Certified Nonprofit Healthcare Corporation Who can grant a title of Certified Nonprofit Healthcare Corporation? - ansTMB What are 5 important characteristics of Certified Nonprofit Healthcare Corporations? - ansMust conduct scientific research, support education, improve capabilities to study and teach, deliver health care to the public, instruct public in medical science, public health Can hospitals provide "physician guarantees"? How do the finances work? - ansPhysicians can contract with hospitals but are not employees; guarantees paid for availability, billing, etc Are there federal anti-kickback laws? - ansYes What does the health care insurance portability and accountability act do to federal anti- kickback provisions? - ansApplies to all federal health care insurances = all insurances Do the anti-kickback laws apply only to Medicare and Medicaid? - ansNo Does federal anti-kickback law apply only to patient referrals? - ansNo Does this law apply only to giving money as a kickback? Who is punished, giver or taker? - ansNo, any money or monetary value; both are punished What kind of crime is a violation of anti-kickback law, and what is the penalty for physicians and hospitals? - ansFelony; up to $250,000 for individuals and $500,000 for institutions What are safe harbors in anti-kickback law? Give examples. - ansActs NOT in violation of anti-kickback regulation; e.g., space and equipment rental, sale of practice, discounts, etc Are STARK laws federal? - ansYes What is a STARK law? Can you refer to family? - ansAnti-self-referral law; no What is the difference between STARK 1 and STARK 2? - ansStark 1 applies to laboratories, Stark 2 to PT, OT services, etc What is the CIVIL FALSE CLAIMS act? Is it state or federal? How long has it been around? What does it prohibit? - ansSubmitting false claims to government for payment; federal law since War Between the States Does Texas prohibit remuneration in exchange for referral volume? - ansYes, prohibition on the solicitation of patients What kind of crime is it to tamper with Texas Medical Board documents? - ansClass A Misdemeanor Barratry—what is it? Is it illegal? - ansContacting prospective patients in attempts to solicit them; it is illegal Who can be part of a medical peer review committee? - ansPhysicians, health care workers, anybody in the hospital Does physician competency include membership in societies, participation in education, participation in group plans? - ansNo Who makes rules (by laws) for hospitals? - ansThe governing body Can a hospital reject an orthopedist because he is a DO and not an MD? - ansNo
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Can a hospital deny you privileges because you don't accept HMOs? Participate in other hospitals? - ansNo Who makes the final decision in a hospital to grant or deny privileges to a physician? - ansGoverning body Does the hospital have to get a report from the NPDB about physicians prior to granting privileges? - ansYes, initially and every 2 years; if they don't, they are liable How many days does the board have to give data to a hospital requesting it? - ans15 days How often must a physician update his core credentials? How many days does he have to provide corrections? - ansYearly; corrections within 30 days Prior to the "first release" of his information, how many days does a physician have to review it? - ans15 business days If a physician's privileges will be suspended, does he/she have the right to due process? - ansYes How many days prior to hearing of due process must the hospital give the physician notification? - ans30 days Do hospitals have to accept NPs and PAs? - ansNo If accepting NPs and PAs, what are the hospital's responsibilities? - ansDue process, fairness, appeal Is the peer review file confidential? - ansYes, EXCEPT for possible civil rights violation and possible anti-trust violation When must a hospital's medical peer review report actions taken against physicians to the TMB? to the HCQIA? to the NPDB? - ansIf action affects privileges for longer than 30 days or if physician surrenders privileges or if it affects membership; never, the TMB reports to NPDB How much time does the committee have to report to the TMB? - ans15 days Is it good enough to get the signature for informed consent? - ansNo, actual informed consent must be achieved Which procedures need "full disclosure" of LIST A and LIST B? - ansOnly List A Which procedures need additional "statutory consent"? - ansHysterectomy, radiation therapy, ECT Is it the duty of the hospital or the physician to get consent? - ansPhysician Which particular aspects of an informed consent if neglected can be grounds for a suit? Do you need to suffer damages to sue? - ansNondisclosure of risks, benefits, alternatives; yes Is express consent required in an emergency? - ansNo, consent is implied If arrested and suspected to be drunk, do the police need consent to check blood? - ansNo, consent is deemed to have been made, but consent can be expressly denied If anyone died in an accident, is consent needed to check blood? - ansNo Who is a minor in Texas? - ansAnybody less than 18 years of age who has not been emancipated When can a minor petition the court NOT to be a minor? - ansAge 16 when living independently and supporting self, age 17 when supporting self, managing conservator or guardian, Texas resident Can an uncle consent for a minor? - ansYes
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If you see a DNR device on a patient but have not seen the form, is that enough not to give treatment? - ansYes, DNR device is enough Can an incompetent patient revoke their DNR? - ansYes Should this form accompany patients on transfers? - ansYes What kind of treatment can the power of attorney NOT consent to? - ansAdmission to mental health institution, ECT, psychosurgery, abortion, neglect of minimal treatment (nutrition, hydration, comfort measures) Does the power of attorney have an expiration date? - ansNo, unless specified What happens if on the expiration date the patient is incompetent? - ansIt is continued until patient becomes competent again, then expires Who cannot be the power of attorney? - ansPrincipal health care provider or residential care provider or employee of those Does the power of attorney have access to the patient's medical records? - ansYes When can you withhold treatment to an infant? - ansIf chronically and irreversibly comatose or terminally ill and further treatment would be futile Can you withhold nutrition/hydration from a terminally ill infant? - ansNo Is the mental health directive an advanced directive act? - ansYes, but with differences What are the requirements for mental health directive? What are requirements for witnesses?
- ansAge 18 or not a legal minor, not incapacitated; 2 witnesses both of who cannot be related, beneficiaries, attending physician, or employees of hospital Does a mental health directive have an expiration date? - ansYes, 3 years or until revoked What happens if on the expiration date of a mental health directive, the patient is incapacitated? - ansIt continues until competent When can you use restraints? When can you use behavioral measures? - ansIf there is danger of harm to self or others and other measures have failed; never Does the donor have rights of a parent in artificial insemination? Does the husband? - ansDonor NO, husband YES What prenatal maternal tests must a physician check? - ansHIV, hepB, syphilis How many times must a physician check prenatal maternal tests? - ansTwice; upon first examination and on admission for delivery Are prenatal maternal tests confidential and anonymous? - ansConfidential; anonymous upon request Does the physician have to tell the mother that he/she will do prenatal maternal tests? What if she wants anonymous testing? - ansYes, must inform but not specifically consent; if anonymous is wanted must refer patient to anonymous testing center; patient can refuse If prenatal maternal tests are positive, what must the physician do? - ansRefer for treatment, provide counseling, and provide information about diseases How long does a physician have to keep prenatal maternal test results? - ansFor 9 months What institutions do not need licensing for birthing centers? - ansLicensed hospitals, nursing homes, and ambulatory surgery centers What does the federal case Roe v. Wade say about abortion? - ansAbortions are legal Under what circumstance can you perform a third trimester abortion in Texas? - ansIn emergency to save mother's life or if fetus has severe irreversible abnormality
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After third-trimester abortion, how many days does the physician have to notify the Department of Health? - ans30 days What is the cut-off gestational age to do an abortion in the office? - ans16 weeks What specific health risk must you inform the patient about during consent for abortion ( categories)? - ansInfection, hemorrhage, infertility, breast cancer What specific economic-related issues must you talk about during consent for abortion? Do you need to document in writing that you talked about these issues? - ansMedical assistance, father's liability for support; yes How long before the abortion must you tell patients about risks and economic issues? - ans hours When can you perform an abortion on a minor? Can you do it without calling the parents? - ansTo save mother's life, court order, consent of parents; yes, only court ordered How much time prior to an abortion on a minor must you give notification to parents? If they agree, can you do it earlier? - ans48 hours; yes What happens if you cannot find a parent to notify of abortion? - ansMail certified letter 48 hours prior Is there any way for a minor to have abortion without notifying the parents? - ansYes, can petition court if minor is mature, informed and notification may be harmful (abuse) To perform emergency abortion on a minor, what must you do? What kind of form to fill out?
- ansAssure that it is necessary; notify TDDHS on prepared form What facility must be licensed to do abortions in Texas? - ansIf they do > 50/year How often do abortion facilities have to report to the DPH? - ansYearly Do abortion facilities' reports include the physician and patient names? - ansNo, neither Can you force a physician to perform an abortion? - ansNo With what and for what do you have to treat all newborns? - ansOphthalmia neonatorum, tetracycline, erythromycin, or silver nitrate ophthalmic solution What genetic test must you do on all newborns? How many times? Who can do them? Can the parents object? - ansPKU, galactose- 1 - phosphate uridyltransferase deficiency, sickling hemoglobinopathies, congenital adrenal hyperplasia, hypothyroidism; twice (at birth, 2 weeks later); physician or person attending birth; parents can object on religious grounds Do hospitals have to give hearing test to all newborns? - ansYes Within what time period does insurance have to pay for newborn hearing screen? When do they have to pay for follow-up care with regard to hearing? - ansFrom birth until 30 days; up to 2 years of age For what time period must an insurance cover a mother + newborn? - ans48 hours normal delivery, 96 hours C-section; longer for complicated delivery Who must review immunization history? - ansEvery physician Until when must insurance pay for immunizations? - ansUp to age 6 Who must submit the birth certificate? - ansPhysician, midwife, or person attending birth How many days do you have to submit the birth certificate? - ans5 days What kind of crime is it if you don't submit a birth certificate? - ansMisdemeanor What kind of crime is it if you submit false data on a birth certificate? - ansFelony 3rd degree
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How can you revoke an organ gift? Do you have to tell the donee? - ansYes; no Can you pronounce the death and transplant an organ in the same patient? - ansPhysician who determines death CANNOT participate in transplantation At what age and how can a mentally retarded person donate a kidney? - ansAge 12, by petitioning the district court Can a blood bank pay for blood? How? After how many days? - ansYes, by mailed check, 15 days after donation What is the duty of a medical professional when treating an adult with family violence? What languages to use? - ansDuty to treat and provide information (and document that information was provided) in English and Spanish; no need to report Does the physician have to call the police in cases of adult family violence? - ansNo, just inform victim of options What is the difference between a professional and a medical professional? - ansMedical professional = MD; professional = anybody else, e.g., teacher Reporting of child abuse? By whom? How fast? Can it be delayed? To whom (3 entities)? - ansReport immediately but MUST be within 48 hours, cannot be delegated; to Texas Department of Protective and Regulatory Services, any law enforcement, Texas Youth Commission Will the TDPRS act on anonymous calls regarding child abuse? Does it satisfy a professional duty to report? - ansYes, they will be acted upon but DO NOT satisfy duty to report How much time do professionals and medical professionals have to report the death of a child secondary to suspected abuse? - ans48 hours What kind of crime is lying in a report on child abuse? Not submitting a report? - ansState jail felony, misdemeanor class B Who must report nursing home abuse? - ansAny person Is the report of nursing home abuse verbal or written? - ansImmediately verbally, written within 5 days What kind of offense is it NOT to report nursing home abuse? - ansMisdemeanor class A Can the institution retaliate against a whistle-blower in cases of nursing home abuse? - ansNo When and within what time limit must nursing homes report resident deaths? - ansWithin 10 working days Within what time period must nursing home deaths be reported if the resident just transferred to hospital within 24 hours and died? - ans10 working days Who is considered a child, elderly, or disabled person when talking about a criminal offense for injury of the above? - ans14 year or younger, 65 or older or disabled older than 14 Who is considered "elderly" when living at home? - ans65 or older What kind of offense is it if you do not report elderly abuse? - ansMisdemeanor class A; false information class B Can a volunteer report abuse in a hospital, etc.? - ansYes Who is considered a mental health worker? Does that include priests? - ansSocial worker, addiction counselor, counselor, marriage therapist, clergy member, physician, psychologist; yes
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Give definitions for 4 types of sexual contact - ansTouching, deviate acts, intercourse, request for or suggestion of What is sexual exploitation? - ansPattern for purposes of sexual gratification What is therapeutic deception? - ansMaking patient believe it is part of treatment What of the above questions is cause for action? - ansAll-contact, exploitation, deception Is an employer liable for the sexual misconduct of a current or previous worker with a current or discharged or ex-patient? - ansYes, if employer has knowledge of past sexual exploitation or fails to inquire over the last five years of employment What is considered "emotional dependence"? - ansLack of emotional dependence of the patient on the therapist is a defense that can be raised in an action brought by a former patient Is it a defense that the sexual misconduct was consented? Off the premises? Outside treatment sessions? - ansNo, no, no Who are the 2 agencies that should receive a report in cases of sexual misconduct? - ansState licensing board and prosecuting attorney of the county where the alleged offense occurred When to report sexual misconduct? What offense is failure to report? - ansWithin 30 days; misdemeanor If you are examining a patient with a communicable disease, what is your duty? - ansDuty to instruct on prevention of reinfection, spread, and necessity to treat Who has to report communicable diseases? - ansPhysician, dentist, veterinarian, chiropractor What sort of situations must be reported? - ansDocumented or suspected infection, exotic diseases, outbreaks Can an employee in the office do the reporting? - ansYes, if designated by physician If a physician reports a communicable disease, does the hospital also have to report it? - ansYes, both If you treat a patient with a communicable disease that dies, what are your 2 responsibilities and within what time frame? - ansReport death immediately and put toe tag on What kind of crime is nonreporting communicable disease? - ansClass B misdemeanor If you are a police officer, firefighter, etc., can you make somebody have an HIV test if you think you might have been exposed? Who do you call? - ansYes, request TDH Is the police officer, etc., required to be tested himself/herself? - ansNo If an employee is exposed, can the hospital check if the person is harboring an infective agent? - ansYes, to HepB, C, HIV What diseases must they test for? - ansHep B, C, HIV Do they need the patient's consent? - ansNo Who must report occupational exposure? Does that include labs? - ansPhysicians, labs, health care workers; labs must report abnormal lead levels What occupational exposure must be reported? - ansAsbestosis, silicosis Do you have to report birth defects? - ansYes Which diseases have to be reported immediately? - ansDiphtheria, measles, anthrax, pertussis, hemophilus, plague, rabies, SARS, smallpox, yellow fever, etc Which diseases must microbiology labs report immediately? - ansVancomycin-resistant staph, VRE, HIV, neisseria meningitis
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Licensing
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Can psychiatry hospitals employees' pay be based on # of admissions, length of stay, calls to referring sources? - ansNo Can psychiatry hospitals "guarantee" a cure on advertising? - ansNo Can psychiatry hospitals solicit information about patients' confidential records to solicit them for services? - ansNo Can a physician send a patient directly to psychiatry hospital? Do they have to first get insurance approval? - ansYes; no How long is a mental health directive valid for? - ans3 years or earlier if revoked Does a mental health directive suffice to allow ECT treatment? - ansYes, it is considered a prior consent Does Texas have "duty to warn" for mentally-ill patients? Is this breach of confidentiality - ansTexas does NOT have duty to warn, it IS a breach of confidentiality Can patient refuse mental health treatment after admission? - ansIf they are voluntarily admitted, yes; if involuntarily, no, with court order Who does EMTALA apply to? - ansHospitals participating in Medicare What is considered "campus"? - ans250 yards from ER What 4 places constitute "coming" to the ER? - ansIn hospital-owned ambulance or air transport, or patient is in ER or in hospital requesting ER consultation If an ambulance despite being told that the hospital is on diversion comes to the ER, can you send them away? - ansNo, patient HAS TO BE SEEN Is pregnancy a medical emergency? - ansNo, except for complications and labor Under EMTALA, what MUST a hospital provide? - ansMedical screening Is it enough to log in or triage the patient? - ansNo Can you delay treatment in order to check insurance? Get pre-approval? - ansNo Can you provide different levels of care based on insurance? - ansNo Can a PA or NP provide the EMTALA required screening? - ansYes Does admitting the patient for treatment satisfy EMTALA requirements? - ansNo If patient refuses treatment, does that satisfy EMTALA? What is the appropriate protocol? - ansYes; has to be informed of potential dangers If a physician is not available to determine if transfer is necessary, who else can do it? What is required? - ansPA, NP, RN, other qualified person after consultation with MD Do you have to send medical records when transferring from an ER? - ansYes Can you transfer because on-call physician did not show up? What must you do? - ansYes; record name and address of physician who did not show up Can a specialized hospital (e.g., burn unit) refuse a transfer because "they are full"? - ansNo, if they have EVER accepted patients before and made room for them How many years must you keep records of patient transfers? - ans5 years Do hospitals need to keep on-call lists? - ansYes Can you do elective surgery when you are on call? - ansYes Can on-call physician refuse to show up? - ansNo, only in circumstances beyond his control What are the 3 penalties for hospitals and physicians for violation of EMTALA? What is the maximum damage? - ansCivil money penalties, termination of provider agreement, civil action. Up to $50,000 per violation ($25,000 for < 100 beds)
Exam:
Your Ultimate Guide to Success in Legal
Licensing
Current Updated Exam Study Guide
Can a patient initiate his/her own transfer? - ansYes How many people on the Texas Medical board? - ans How many MDs on the TMB? - ans How many layperson on the TMB? - ans How often does the police run a check on physicians? - ansMonthly How often does the TMB put out reports on physicians? - ansEvery 6 months How many years of postgraduate training to apply for full license? - ans If a resident does not show up to begin his training, how many days does the program director have to report that to the board? - ans Institutional permit: how many months for initial license? How many renewals? How many months for each renewal? - ans14 months; 7; 12 months Physician-in-training permit: how many months for initial license? How many renewals? How many months for each renewal? - ans18 months; 6; 18 months How often do you register your license with the TMB? - ansEvery 2 years How many days prior to expiration of your license does the board notify you? - ans How many days after expiration are you considered practicing without a license? - ans How many days after expiration is license canceled? - ans How many category 1 CMEs per year? - ans How many ethics CME credits? - ans1 yearly How many CME credits can be from volunteering? - ans How many CMEs can you carry forward? - ans How often must the board give update to all participants in a complaint? - ansEvery 3 months (quarterly) How much time do insurances have to report malpractice to the board? - ans30 days If disciplinary action is taken by the board, how much time to report to the hospital verbally? In writing? To the NPDB? - ansVerbally immediately to hospitals on first working day; in writing to all hospitals and agencies within 30 days. How much time to report court reports to the board? - ans30 days How many malpractice claims in what time frame to trigger board investigation? - ans within 5 years How many people from the board to emergency suspend license? - ans How many days does a physician have to file appeal to a board decision? Which county? - ans30 days; Travis county How soon and how often can you file for reinstatement of a license? - ansAfter one year; once a year. Maximum administrative penalty by board? By attorney general? - ans$5000 per violation; $1000 per violation. How much time to pay an administrative penalty by the board? - ans30 days. How many days can NPs and PAs prescribe? How many refills? For patients how old? - ans30 days, no refills; older than 2 years. How many PA equivalents can an MD supervise? - ans3 full-time employees What percentage of random charts of the PA must the physician review? - ans10% How far can secondary practice sites be located from primary? - ans60 miles
