Certification Review Guide
**Question 1.** Which element is essential for a Code of Conduct to be effective in a
healthcare compliance program?
A) Lengthy legal citations
B) High‑level mission statement only
C) Clear, plain‑language expectations for ethical behavior
D) Annual board approval only
Answer: C
Explanation: A Code of Conduct must be written in plain language so all employees understand
the ethical expectations; overly legalistic language reduces accessibility.
**Question 2.** When developing a policy for the Anti‑Kickback Statute, which of the following
should be included to qualify for a Safe Harbor?
A) Unlimited compensation for referrals
B) Written agreement detailing the business purpose and fair market value
C) Verbal assurances of compliance
D) No documentation required if the arrangement is “minor”
Answer: B
Explanation: Safe Harbors require a written agreement that specifies a legitimate business
purpose and that compensation reflects fair market value.
**Question 3.** The primary purpose of periodic policy review schedules is to:
A) Reduce the workload of the compliance officer
B) Ensure policies reflect current laws and regulations
C) Increase the number of policies in the manual
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Certification Review Guide
D) Provide an excuse for staff to attend meetings
Answer: B
Explanation: Regular review aligns policies with evolving statutes such as updates to the No
Surprises Act.
**Question 4.** Which reporting line best demonstrates the independence of a compliance
officer?
A) Reports to the Chief Financial Officer
B) Reports directly to the governing board or board chair
C) Reports to the human resources manager
D) Reports to the department with the highest revenue
Answer: B
Explanation: Direct reporting to the board or board chair ensures independence from
operational pressures.
**Question 5.** A compliance committee should meet at least:
A) Once a year
B) Quarterly, with additional meetings as needed for high‑risk issues
C) Every day
D) Only when a violation occurs
Answer: B
Explanation: Quarterly meetings provide regular oversight while allowing flexibility for emerging
risks.
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Certification Review Guide
**Question 6.** Board members’ fiduciary duty in healthcare compliance primarily involves:
A) Maximizing short‑term profits
B) Overseeing the organization’s compliance with applicable laws and regulations
C) Delegating all compliance responsibilities to staff
D) Ignoring regulatory updates
Answer: B
Explanation: Fiduciary duty includes ensuring the organization complies with laws, protecting
the entity from legal and financial exposure.
**Question 7.** Which of the following is a key component of budgeting for a compliance
program?
A) Purchasing luxury office furniture for the compliance office
B) Allocating funds for staff training, audit tools, and external legal counsel
C) Funding only the compliance officer’s salary
D) Reducing the compliance budget each year
Answer: B
Explanation: Adequate resources for training, technology, and expert advice are essential for an
effective program.
**Question 8.** Mandatory compliance training for coders and billers should primarily address:
A) General customer service etiquette
B) Specific billing code usage, documentation requirements, and fraud detection
C) Marketing strategies for the organization
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Certification Review Guide
D) Personal finance management
Answer: B
Explanation: Coders and billers need targeted instruction on accurate coding, documentation,
and identifying potential fraud.
**Question 9.** To evaluate the effectiveness of a training program, an organization should:
A) Assume training is effective if attendance is high
B) Use post‑training tests and surveys to measure knowledge retention
C) Rely solely on anecdotal feedback from managers
D) Conduct the training once and never assess again
Answer: B
Explanation: Objective testing and surveys provide measurable data on knowledge retention
and training impact.
**Question 10.** An open communication channel between staff and the compliance officer
helps to:
A) Increase the number of complaints filed
B) Encourage reporting of potential violations without fear of retaliation
C) Reduce the compliance officer’s workload
D) Limit staff interaction to formal meetings only
Answer: B
Explanation: Open channels foster a culture where employees feel safe to report concerns,
supporting early detection of issues.