(MASTER FLASHCARDS) and
Answers Updated 2026
TrueAorAFalse:
TheAACAArequiresAthatAallAprovidersAadoptAaAcomplianceAplanAasAaAconditionAof
AenrollmentAwithAMedicare,AMedicaid,AandAChildren'sAHealthAInsuranceAProgramA
(CHIP).A-AAnswerATrue
ref.AACAAsectionA6102
AccordingAtoAHHS-OIGA-
AwhatAareAthreeAimportantAreasonsAforAproperAdocumentationAinACompliance?A(
hint:Aprotections)A-AAnswerA1.ProtectAourAprograms
2.ProtectAyourApatients
3.ProtectAtheAProvider
https://oig.hhs.gov/newsroom/podcasts/2011/heat/heat09-
trans.asp#:~:text=Proper%20documentation%2C%20both%20in%20patients,to%20pro
tect%20you%20the%20provider.
AtAwhichAlevelAofAtheAMedicareAPartAAAorAPartABAappealsAprocessAisAtheAappe
alAdecisionAbyAtheAOfficeAofAMedicareAHearingsAandAAppealsA(OMHA)?
a.AfirstAlevelAofAappeal
b.AsecondAlevelAofAappeal
c.AthirdAlevelAofAappeal
d.AfourthAlevelAofAappealA-AAnswerAc.A.AthirdAlevelAofAappeal
FristAlevelA-AredeterminationAbyAMedicareAcontractor
SecondAlevelA-AreconsiderationAbyAIndependentAcontractor
ThirdAappealA-AAdministrativeALawAJudgeA(ALJ)Ahearing
FourthAappealA-AreviewAbyAMedicareAAppealsACouncil
FifthAappealA-AreviewAinAFederalADistrictACourt
,https://www.hhs.gov/about/agencies/omha/the-appeals-process/index.html
WhatAshouldACCOAbeAableAtoAdo?A(WhatAskillsAshouldAthisApersonAhave?)AChoo
seAallAthatAapply.
a.ALeadershipAskills.
b.AOverseeAtheAcodingAdepartment.
c.ASkillsAtoAdesignAandAimplementAaAcomplianceAprogram.
d.ABeAableAtoAanticipateAnewAriskAareas.
e.APracticalAexperienceAwithAdocumentingAmedicalAnecessity.A-
AAnswerAa.ALeadershipAskills,
c.ASkillsAtoAdesignAandAimplementAaAcomplianceAprogram,Aand
d.ABeAableAtoAanticipateAnewAriskAareas.
WhichAofAtheAfollowingAisAanAabsoluteAnecessityAinAorderAtoAhaveAaAsuccessfulA
ComplianceAProgram?
a.AcontinuousAtrainingAandAimprovements
b.AeffectiveAreportingApath
c.Anon-retaliationAforAwhistleblowers
d.AreliableAandAequalAdisciplineA-AAnswerAc.Anon-retaliationAforAwhistleblowers
AAComplianceAProgramAwithAwellAwrittenApoliciesAandAprocedures:
a.AcanAbeAsuccessfulAifAconsistentlyAreviewedAandAmaintained
b.AcannotAbeAeffectiveAdueAtoAtheAsheerAvolumeApresented
c.AwillAbeAeffectiveAifAreadAbyAmanagement
d.AwillAnotAbeAsuccessfulAwithoutAtheAproperAoversightA-
AAnswerAd.AwillAnotAbeAsuccessfulAwithoutAtheAproperAoversight
RegardlessAofAhavingAtheAbestAwrittenApoliciesAinAplaceAthatAareAreviewed/maint
ainedAconsistently,AandAreadAandAdisseminatedAaccordingly,AwillAfailAifAthereAisA
noAproperAoversightAtoAensureAtheyAareAactuallyAbeingAfollowedAandAunderstood.
AAComplianceAOfficerAcanAachieveAaAhigherAlevelAofAcomplianceAandAethicsAeng
agementAby:
,a.AensuringAleadershipAreadsAtheApolicies
b.AincreasingAmanagementAinvolvement
c.ArespondingAtoAcomplianceAhotlineAcalls
d.AmonitoringAtheAcodeAofAconductA-
AAnswerAb.AincreasingAmanagementAinvolvement.
ComplianceAisAeveryone'sAresponsibility,AbutAmanagementAinvolvementAisAcrucial.
ATheyAhaveAaAdirectAcontactAwithAemployees,AtheyAknowAandAunderstandAtheirA
staff'sAneedsAandAconcerns,AandAhaveAtheAmostAinfluenceAoverAemployee'sAactio
nsAandAattitudes.AEmployeesAmostAlikelyAuseAtheirAdirectAmanager(s)AtoAraiseAc
oncernsAandAtheAreasonAtheyAareAsoAcriticalAforAanAorganizationAtoAfosterAaAcul
tureAofAcompliance.
WhichAofAtheAfollowingArequiresAprovidersAtoAbeApermanentlyAexcludedAfromAall
AfederalAhealthAcareAprogramsAifAfoundAguiltyAofAaAhealthcareArelatedAfraudAaA
thirdAtime:
a.ADeficitAReductionAActAofA2005
b.AFalseAClaimsAAct
c.ABalanceABudgetAActAofA1997
d.ASocialASecurityAActAsectionA1128dA-AAnswerAc.ABalanceABudgetAActAofA1997
AlsoAknownAasAaABBAA"threeAstrikesArule"
WhatAsectionAofAtheAACAApreventsAdiscriminationAagainstAindividualsAwithAlimite
dAEnglishAproficiencyA(LEP),AandAalsoAprohibitsAdiscriminationAinAhealthcareAprog
ramsAandAactivitiesAthatAreceiveAfederalAfunding,AbasedAonArace,Acolor,Anational
Aorigin,Asex,Aage,AorAdisability.
a.AACAAsectionA6102
b.AACAAsectionA1557
c.AACAAsectionA6002A-AAnswerAb.AACAAsectionA1557AisAtheAcorrectAAnswer.
a.AACAAsectionA6102ArequiresAowners,Aoperators,AandAadministratorsAofALTCAfac
ilitiesAtoAadoptAeffectiveAcompliance.
, c.AACAAsectionA6002ArequiresAtheAestablishmentAofAaAtransparencyAprogram,Ano
wAknownAasACMSAOpenAPayments.
WhichAstatementAisATRUEAregardingAcomplianceAprograms?
a.AComplianceAprogramsAareAconsideredAmoreAdangerousAifAtheyAareAdeveloped
AbutAnotAimplemented.
b.AComplianceAprogramsAcanAdetectAbutAnotApreventAcriminalAconduct
c.AComplianceAprogramsAareAonlyArequiredAbyAlawAforAhealthcareAentitiesAthatAh
aveAmoreAthanA$500,000AinAannualArevenue.
d.AComplianceAprogramsAareAnotAmandatedAbyAlaw.A-
AAnswerAa.AComplianceAprogramsAareAconsideredAmoreAdangerousAifAtheyAareAd
evelopedAbutAnotAimplemented.
AnAindividual'sAunderstandingAofAtheAcomplianceAaspectsAofAtheirAjobAcanABEST
AbeAenhancedAbyAincludingAcomplianceAin:
a.AannualAevaluations
b.AexitAinterviews
c.AHRAbenefitAmaterials
d.AauditAcommitteeAmeetingsA-AAnswerAa.AannualAevaluations
FormalAstatementAoutliningAaAplanAforAaAspecifiedAsubjectAarea.AItAusuallyAcites
AstateAand/orAfederalArequiredAactionsAorAstandards.
a.ACAP
b.AProcedureAdocument
c.APolicyAdocument
d.ALegalAstandardsA-AAnswerAc.APolicyAdocument
CAPA-AoutlinesAcorrectiveAactionAplan
ProcedureA-AdescribesAprocess/stepsAunderAaAcertainAcriteria
LegalAstandardsA-AmandatoryAactionAorArule
LifeAcycleAofArecordsAmanagementA-AAnswerACreation
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