Cybersecurity
What is "individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral?
What is protected health information (PHI)?
Who can make a service determination request?
What is the participant, their designated representative or unpaid caregiver?
Who are the members that comprise the IDT?
Who are:
PCP, RNCM, MSW, PT, OT, RD, AC, HCC, PCA, Transportation coordinator
What (3) disciplines are required to complete the following assessments: semi-annual, initial, change of condition?
What are PCP, RN, and MSW?
What is the federal law that addresses the use and disclosure of an individual’s protected health information by organizations subject to the Privacy Rule and protects an individuals’ right to understand and control how their health information is used?
What is Health Insurance Portability and Accountability Act (HIPAA)?
What is the timeframe to notify the participant or their designated representation of the IDT's decision?
What is no later than 3 calendar days after the date the interdisciplinary team receives the request?
True or False:
The PACE Organization is required to report enrollment data, immunizations and medications errors to CMS.
What is true?
How many days after an in-person assessment must careplanning occur?
What is 30 days?
True or false: PHI includes a patient’s name, address, and Social Security number.
Answer: True
Explanation: PHI includes any information that can be used to identify a patient, such as name, address, Social Security number, and more.
What is the timeframe for a request to come to the IDT after it is made?
What is as expeditiously as the participant's condition requires, but no later than 3 calendar days from the time the request is made?
What is a participant's action taken with respect to the PACE organization's noncoverage of, or nonpayment for, a service including denials, reductions, or termination of services?
What is an appeal?
What is the maximum timeframe for the IDT to complete in-person assessments and complete (review and revise) the care plan for unscheduled reassessments (change in condition/status)?
What is 14 calendar days?
What is the fraudulent practice of sending emails or other messages appearing to be from reputable companies in order to induce individuals to reveal personal information, often delivered via email spam?
What is phishing?
The team members performing the reassessment must evaluate whether the requested service is necessary to meet the participant's _______ (needs)?
What is medical, physical, emotional, and social needs?
On enrollment into PACE participants agree to receive all care through the PACE network, with the exception of what?
What is Emergency Services?
At least once every ______ days from the date the latest plan of care was finalized the interdisciplinary team must complete a reevaluation of, and if necessary, revisions to each participant's plan of care?
What is 180 calendar days?
What is a virtual network that is an encrypted connection over the Internet that can provide a secure communications mechanism between networks?
What is the Virtual Private Network (VPN)?
True or false: The PACE organization can use an extension if it is in the participant's interest because the interdisciplinary team needs additional information from an individual employed by the PACE organization?
What is false?
The interdisciplinary team may extend the timeframe for review and notification by up to 5 calendar days if either of the following occur:
(i) The participant or other requestor requests the extension.
(ii) The extension is in the participant's interest because the interdisciplinary team needs additional information from an individual not directly employed by the PACE organization that may change the interdisciplinary team's decision to deny a service.
In the early 1970’s a community in San Francisco saw a pressing need for long-term care services for those whose elders had immigrated from Italy, China, and the Philippines. What was the name of the program that was created from this need and served as the first “PACE” center (although it wasn’t called this at the time)?
What is On Lok?
Safety plans are part of _______, therefore should be evaluated during care planning sessions?
What is the plan of care?