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Law Review Exam 1

alchemist04's version from 2018-10-05 03:18


Question Answer
HIPAA isthe Health Insurance Portability and Accountability Act, It regulates the privacy and security of health information
List four aspects of health information under HIPAATransaction and Code sets (T and C), National Provider Identities (NPI), Security, Privacy
A “limited data set” isa PHI that excludes direct identifiers of the patient
What is TPO?Means Treatment, Payment and Operation. These are exclusion from PHI
Define HITECHHealth Information Technology for Economy and Clinical Health
PHIProtected Health Information


Question Answer
DURDrug Use Review, Prospective Review, Educational program, Retrospective Review
List items a pharmacist must do under OBRA ’90A screen of prescriptions before dispensing, Patient counseling by the pharmacist, Pharmacist documentation of relevant information
What is the potential penalty for a student accidentally leaving their clinical notes on the bus?of $100 per violation, up to #25,00 per person for all violation in a calendar year
if a breach of PHI has occurred, the pharmacist must notify the affected individual(s)by 1st Class mail (or electronically if the individual has agreed) w/n 60 days after the breach was discovered, for more than 500 individuals, pharmacy must notify the media w/n 60 days and notify DHHS immediately


Question Answer
Identify the four groups covered by Medicare.i. =/> 65 yo , ii. patient w/ permanent disability, iii. End-stage renal disease, iv. those that have been exposed to environmental hazard and have developed health- related sequel as a result of such exposure
List medications that fall on the “excluded” listi. Weight loss or weight gain drugs, ii. Fertility promotion drugs, iii. Erectile dysfunction drugs, iv. Drugs used for cosmetic purposes or hair growth, v. Cough and cold drugs used to treat symptoms, vi. Vitamins and minerals (except prenatal vitamins, niacin, fluoride preparations and certain vitamin D analogs), vii. Outpatient drugs for which the manufacturer requires testing or monitoring
“any willing provider” meaningPart D plan must permit any pharmacy to participate in the plan that meets the term and conditions of the plan
Identify the action required by pharmacy staff upon prescription coverage denial at the point of salePrinted notice must inform the enrolled how to request a coverage determination by contacting the toll-free number of the plan
Violation of AKS is a Felony punishable byi. A minimum of $25,000 per violation, ii. 5 years imprisonment or, iii. both


Question Answer
FULFederal Upper Limit
MACMaximum allowable cost
AACActual Acquisition Cost
EAC1. Estimated Acquisition Cost, 2. is the state Medicaid Agency’s best estimate of what the pharmacists pay for the drug
AWP1. Average Wholesale Price, 2. It is the manufacturer’s suggested price for wholesalers to sell to pharmacies
ERISAEmployee Retirement Income Security Act
NABPNational Association of Board of Pharmacy

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