Exam Prep Payne Crimes In The Health Care System Ch.4

Chapter 4: Crimes in the Health Care System

Test Bank

Multiple Choice

1. Which of the following is an example of white-collar crime in the healthcare industry?

a. unprofessional acts during patient care

b. using medical equipment designed for one use only

c. drug use by a pharmacist

d. installing a camera to monitor a hospital waiting room

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Knowledge

Answer Location: Chapter Introduction

Difficulty Level: Medium

2. Why did Sutherland provide little discussion about doctors in his research into white-collar crime?

a. He considered most incidents involving doctors to be accidental in nature.

b. He classified most of the crime in the healthcare industry under insurance fraud.

c. He wanted to leave the regulating to the medical boards.

d. He believed doctors were more honest than other professionals.

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Knowledge

Answer Location: Fraud by Doctors

Difficulty Level: Easy

3. Why is it easier for investigators to prove fraud in the mental health professions?

a. The way their records are kept leaves little room for error.

b. It cannot be claimed as an accident.

c. It is easier to prove time violations.

d. It is easier for insurance companies to catch.

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Knowledge

Answer Location: Fraud by Doctors

Difficulty Level: Easy

4. Which of the following form of fraud occurs when a doctor or healthcare professional bills Medicare/Medicaid for a service that was not provided?

a. unbundling

b. misrepresenting services

c. upcoding

d. phantom treatment

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Knowledge

Answer Location: Fraud by Doctors

Difficulty Level: Easy

5. If a hospital employee performs a procedure that they are not authorized to perform, what type of fraud is being committed?

a. misrepresenting services

b. substitute providers

c. unbundling

d. pingponging

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Knowledge

Answer Location: Fraud by Doctors
Difficulty Level: Medium

6. Which of the following is the main reason for the occurrence of unnecessary surgeries in the healthcare industry?

a. Medical providers agree most of the time about performing surgery, necessary or not.

b. Patients trust surgery more than taking medication.

c. There are mistakes made in diagnosis or reading of tests.

d. Patients are willing to have a procedure to be “cured ” even if the ailment would go away on its own.

Learning Objective: 4-6: Define unnecessary surgery and medication errors and the impact of each.

Cognitive Domain: Knowledge

Answer Location: Unnecessary Surgery
Difficulty Level: Easy

7. Why are there high rates of occurrence for medication errors in the month of July than any other month?

a. New doctors and residents begin practicing in July.

b. There are more patients in the hospital in the middle of the summer.

c. Doctors who fill-in for colleagues are unfamiliar with the patients and their medication history.

d. It is unknown why.

Learning Objective: 4-6: Define unnecessary surgery and medication errors and the impact of each.

Cognitive Domain: Knowledge

Answer Location: Medication Errors

Difficulty Level: Medium

8. What category of crimes by healthcare providers does deceiving a medical board fall into?

a. fraud

b. general offending

c. medical malpractice

d. abuse

Learning Objective: 4:1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Knowledge

Answer Location: General Offending by Doctors

Difficulty Level: Medium

9. Why is telehealth fraud becoming a growing problem?

a. Certain crimes can be committed more easily through telemedicine.

b. It is easier for telehealth offenders to make physical contact with patients.

c. Users of telehealth services must share their medical history online.

d. Telehealth offenders can sell more services to patients through online meetings.

Learning Objective: 4-5: Explain why fraud and abuse in telemedicine is rapidly increasing.

Cognitive Domain: Knowledge

Answer Location: Telemedicine Fraud
Difficulty Level: Medium

10. What is the most serious issue facing telehealth providers and their patients?

a. building a trusting relationship between telehealth provider and patient online

b. getting patients to keep their online appointments

c. providing security for patients’ personal and medical information online

d. getting patients to fully discuss their medical issues during appointments

Learning Objective: 4-5: Explain why fraud and abuse in telemedicine is rapidly increasing.

Cognitive Domain: Knowledge

Answer Location: Telemedicine Fraud

Difficulty Level: Medium

11. A pharmacist who fills a customer’s prescription with fewer pills than prescribed by a physician has committed what type of crime?

a. mislabeling drugs

b. phantom treatment

c. double billing

d. short counting

Ans. D

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Comprehension

Answer Location: Fraud by Pharmacists

Difficulty Level: Medium

12. Why is substituting generic drugs for a patient considered a crime?

a. The patient is misled.

b. The doctor continues to treat the patient assuming they are on the medication that was prescribed.

c. The insurance company is billed for the more expensive medication.

d. The practice is unfair to doctors.

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Knowledge

Answer Location: Fraud by Pharmacists
Difficulty Level: Easy

13. What is a common reason that authorities have a difficult time convicting pharmacists of crimes related to dispensing drugs?

a. Pharmacists claim to not be able to read a doctor’s handwriting.

b. There is little or no proof.

c. Pharmacists claim the crime was a simple accident or mistake.

d. The laws in place have several loopholes.

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Knowledge

Answer Location: Fraud by Pharmacists
Difficulty Level: Medium

14. Why is drug use among pharmacists such a large problem, more so than in other professions?

a. Pharmacists have easy access to drugs.

b. Pharmacists think because they have such a trusted position they will never get caught.

c. Pharmacists fall victim to the paradox of familiarity.

d. What pharmacists consider self-medicating others consider illegal drug use.

Learning Objective: 4-2: Understand the difference between fraud and abuse and why doctors engage in these crimes.

Cognitive Domain: Comprehension

Answer Location: Drug Use by Pharmacists
Difficulty Level: Medium

15. A patient who falls in love with their doctor and initiates a sexual encounter is experiencing which type of healthcare provider/patient relationship?

a. mental health controlling relationship

b. drug-induced relationship

c. power and prestige relationship

d. sexual assault

Learning Objective: 4-4: Understand the various relationships that result in sexual abuse of patients and healthcare providers.

Cognitive Domain: Comprehension

Answer Location: Sexual Abuse
Difficulty Level: Medium

16. What type of abuse occurs while a provider is caring for a patient?

a. power/prestige relationship

b. drug-induced relationship

c. sexual assault

d. mental health controlling relationship

Learning Objective: 4-4: Understand the various relationships that result in sexual abuse of patients and healthcare providers.

Cognitive Domain: Comprehension

Answer Location: Sexual Abuse
Difficulty Level: Medium

17. What category of white-collar crime in the healthcare industry would failure on the part of providers to report suspicions of a crime fall into?

a. elder abuse by healthcare workers

b. patient abuse

c. medical malpractice

d. general offending

Learning Objective: 4-3: Describe the reasons for and the types of abuse committed by elder and home healthcare workers.

Cognitive Domain: Knowledge

Answer Location: Elder Abuse by Health Care Workers

Difficulty Level: Medium

18. What is one of the main reasons that healthcare providers abuse elderly patients?

a. There is a lack of awareness.

b. The elderly rarely reports it.

c. The elderly can be difficult patients.

d. Stress

Learning Objective: 4-3: Describe the reasons for and the types of abuse committed by elder and home healthcare workers.

Cognitive Domain: Comprehension

Answer Location: Elderly Abuse by Health Care Workers

Difficulty Level: Medium

19. Which type of elderly abuse occurs more often than physical abuse?

a. neglect

b. financial abuse

c. sexual abuse

d. emotional abuse

Learning Objective: 4-3: Describe the reasons for and the types of abuse committed by elder and home healthcare workers.

Cognitive Domain: Knowledge

Answer Location: Elderly Abuse by Health Care Workers

Difficulty Level: Easy

20. If a healthcare provider stole a ring from an elderly patient, what category of crime would this fall into?

a. general offending

b. financial abuse of the elderly

c. fraud

d. abuse

Learning Objective: 4-3: Describe the reasons for and the types of abuse committed by elder and home healthcare workers.

Cognitive Domain: Comprehension

Answer Location: Elder Abuse by Health Care Workers

Difficulty Level: Medium

21. What type of elderly patient is more likely to fall victim to sexual abuse by their healthcare provider?

a. physically disabled patients

b. patients with little family involvement

c. cognitively impaired patients

d. patients with more life-threatening illnesses

Learning Objective: 4-3: Describe the reasons for and the types of abuse committed by elder and home healthcare workers.

Cognitive Domain: Comprehension

Answer Location: Elderly Abuse by Health Care Workers

Difficulty Level: Medium

22. Which category of crime sees more offenders with past criminal histories?

a. drug use by pharmacists

b. home healthcare fraud

c. sexual abuse

d. elder abuse

Learning Objective: 4-3: Describe the reasons for and the types of abuse committed by elder and home healthcare workers.

Cognitive Domain: Knowledge

Answer Location: Home Health Care Fraud

Difficulty Level: Medium

23. What category of crime includes providing unnecessary services and negative charting?

a. fraud by doctors

b. elderly abuse

c. general offending

d. home healthcare fraud

Learning Objective: 4-3: Describe the reasons for and the types of abuse committed by elder and home healthcare workers.

Cognitive Domain: Knowledge

Answer Location: Home Health Care Fraud

Difficulty Level: Medium

24. How does the medical malpractice category of crime differ from other categories of white-collar crime in the healthcare industry?

a. It never enters the criminal justice system

b. It is not a type of fraud or abuse

c. It is not taken as seriously by authorities

d. It easier for victims to get justice

Learning Objective: 4-7: Describe medical malpractice and how patients are affected when it occurs.

Cognitive Domain: Knowledge

Answer Location: Medical Malpractice

Difficulty Level: Easy

25. How have increasing adverse action reports against physicians affected medical malpractice?

a. Medical malpractice cases have increased due to patients’ access to these reports.

b. Physicians are more careful due to these reports, resulting in decreasing malpractice accusations.

c. More patients are winning malpractice suits because of these reports.

d. Patients avoid physicians who have an alarming number of reports.

Ans: B

Learning Objective: 4-7: Describe medical malpractice and how patients are affected when it occurs.

Cognitive Domain: Comprehension

Answer Location: Medical Malpractice

Difficulty Level: Medium

True/False

1. Unbundling refers to situations where healthcare providers bill for services that are more expensive than the services actually provided.

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Knowledge

Answer Location: Fraud by Doctors

Difficulty Level: Easy

2. Society’s general mistrust of insurance companies has played a role in the large number of unnecessary surgeries or medical procedures performed.

Learning Objective: 4-6: Define unnecessary surgery and medication errors and the impact of each.

Cognitive Domain: Comprehension

Answer Location: Unnecessary Surgery
Difficulty Level: Medium

3. More medication errors take place in the month of July than any other month of the year.

Learning Objective: 4-6: Define unnecessary surgery and medication errors and the impact of each.

Cognitive Domain: Knowledge

Answer Location: Medication Errors

Difficulty Level: Easy

4. If a doctor deceives a medical board, the crime falls under the category of fraud.

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Comprehension

Answer Location: General Offending by Doctors
Difficulty Level: Medium

5. Because pharmacists have been typically been viewed as very trustworthy professionals, more effort and research has focused on them in order to protect the public from something they might not be aware of.

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Comprehension

Answer Location: Fraud by Pharmacists
Difficulty Level: Medium

6. Drug use by a pharmacist is not considered to be white-collar crime.

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Comprehension

Answer Location: Drug Use by Pharmacists
Difficulty Level: Medium

7. Mental health controlling relationships occur when patients become “enamored” with their doctors.

Learning Objective: 4-4: Understand the various relationships that result in sexual abuse of patients and healthcare providers.

Cognitive Domain: Comprehension

Answer Location: Sexual Abuse
Difficulty Level: Medium

8. It is considered a type of elder abuse to not report any suspected incidents of abuse.

Learning Objective: 4-3: Describe the reasons for and the types of abuse committed by elder and home healthcare workers.

Cognitive Domain: Comprehension

Answer Location: Elder Abuse by Health Care Workers

Difficulty Level: Medium

9. Having substitute workers provide medical care in the home healthcare industry is considered fraud.

Learning Objective: 4-3: Describe the reasons for and the types of abuse committed by elder and home healthcare workers.

Cognitive Domain: Comprehension

Answer Location: Home Health Care Fraud

Difficulty Level: Medium

10. Most medical malpractice victims receive some type of retribution from the hospital before the case makes significant progression.

Learning Objective: 4-7: Describe medical malpractice and how patients are affected when it occurs.

Cognitive Domain: Comprehension

Answer Location: Medical Malpractice

Difficulty Level: Medium

Short Answer

1. Describe two examples of fraud that can be committed by a doctor.

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Comprehension

Answer Location: Fraud by Doctors

Difficulty Level: Medium

2. Describe the consequences of medication errors.

Learning Objective: 4-6: Define unnecessary surgery and medication errors and the impact of each.

Cognitive Domain: Comprehension

Answer Location: Medication Errors

Difficulty Level: Medium

3. Describe how pharmacists commonly become addicted to drugs.

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Comprehension

Answer Location: Drug Use by Pharmacists

Difficulty Level: Medium

4. Describe the three different types of offenders who physically abuse the elderly.

Learning Objective: 4-3: Describe the reasons for and the types of abuse committed by elder and home healthcare workers.

Cognitive Domain: Comprehension

Answer Location: Elder Abuse by Health Care Workers

Difficulty Level: Medium

5. Identify the problem with medical malpractice cases and how victims can seek retribution.

Learning Objective: 4-7: Describe medical malpractice and how patients are affected when it occurs.

Cognitive Domain: Comprehension

Answer Location: Medical Malpractice

Difficulty Level: Medium

Essay

1. Discuss three types of fraud committed by doctors and how it affects patients and the healthcare system.

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Comprehension

Answer Location: Fraud by Doctors

Difficulty Level: Medium

2. What is the impact of unnecessary surgeries in the American health care system?

Learning Objective: 4-6: Define unnecessary surgery and medication errors and the impact of each.

Cognitive Domain: Comprehension

Answer Location: Unnecessary Surgeries

Difficulty Level: Medium

3. Discuss three types of fraud committed by pharmacists and the effects on patients and the healthcare system.

Learning Objective: 4-1: Understand the categories of crimes committed by doctors and pharmacists.

Cognitive Domain: Comprehension

Answer Location: Fraud by Pharmacists

Difficulty Level: Medium