AHIP– GENERAL COMPLIANCE FINAL EXAM COMPLETE
QUESTIONS WITH 100% CORRECT ANSWERS
1. Correcting non-compliance ________.
a) Is optional for first-tier entities
b) Protects enrollees, avoids recurrence of the same non-compliance,
and promotes efficiency
c) Only applies to fraud, not waste or abuse
d) Requires immediate termination of the employee involved
Correct Answer: b
2. Once a corrective action plan begins addressing non-compliance for
fraud, waste, and abuse (FWA) committed by a Sponsor's employee or
first-tier, downstream, or related entity's (FDR's) employee, ongoing
monitoring of the corrective actions is not necessary.
a) True
b) False
Correct Answer: b (False)
3. At a minimum, an effective compliance program includes four core
requirements.
,a) True
b) False
Correct Answer: b (False)
(Note: CMS requires seven core compliance program requirements for
Medicare Parts C and D.)
4. What is the policy of non-retaliation?
a) Protects the Sponsor from fines
b) Protects employees who, in good faith, report suspected non-
compliance
c) Requires employees to report only fraud over $10,000
d) Allows termination of whistleblowers if the report is unsubstantiated
Correct Answer: b
5. What are some of the consequences for non-compliance,
fraudulent, or unethical behavior?
a) Disciplinary action only
b) Termination of employment only
c) Exclusion from participating in all Federal health care programs only
d) Disciplinary action, termination of employment, and exclusion from
all Federal health care programs
Correct Answer: d
6. Standards of Conduct are the same for every Medicare Parts C and
D sponsor.
, a) True
b) False
Correct Answer: b (False)
7. Medicare Parts C and D sponsors are not required to have a
compliance program.
a) True
b) False
Correct Answer: b (False)
8. Compliance is the responsibility of the Compliance Officer,
Compliance Committee, and Upper Management only.
a) True
b) False
Correct Answer: b (False)
9. These are examples of issues that can be reported to a Compliance
Department: suspected fraud, waste, and abuse (FWA), potential
health privacy violation, and unethical behavior/employee
misconduct.
a) True
b) False
Correct Answer: a (True)
QUESTIONS WITH 100% CORRECT ANSWERS
1. Correcting non-compliance ________.
a) Is optional for first-tier entities
b) Protects enrollees, avoids recurrence of the same non-compliance,
and promotes efficiency
c) Only applies to fraud, not waste or abuse
d) Requires immediate termination of the employee involved
Correct Answer: b
2. Once a corrective action plan begins addressing non-compliance for
fraud, waste, and abuse (FWA) committed by a Sponsor's employee or
first-tier, downstream, or related entity's (FDR's) employee, ongoing
monitoring of the corrective actions is not necessary.
a) True
b) False
Correct Answer: b (False)
3. At a minimum, an effective compliance program includes four core
requirements.
,a) True
b) False
Correct Answer: b (False)
(Note: CMS requires seven core compliance program requirements for
Medicare Parts C and D.)
4. What is the policy of non-retaliation?
a) Protects the Sponsor from fines
b) Protects employees who, in good faith, report suspected non-
compliance
c) Requires employees to report only fraud over $10,000
d) Allows termination of whistleblowers if the report is unsubstantiated
Correct Answer: b
5. What are some of the consequences for non-compliance,
fraudulent, or unethical behavior?
a) Disciplinary action only
b) Termination of employment only
c) Exclusion from participating in all Federal health care programs only
d) Disciplinary action, termination of employment, and exclusion from
all Federal health care programs
Correct Answer: d
6. Standards of Conduct are the same for every Medicare Parts C and
D sponsor.
, a) True
b) False
Correct Answer: b (False)
7. Medicare Parts C and D sponsors are not required to have a
compliance program.
a) True
b) False
Correct Answer: b (False)
8. Compliance is the responsibility of the Compliance Officer,
Compliance Committee, and Upper Management only.
a) True
b) False
Correct Answer: b (False)
9. These are examples of issues that can be reported to a Compliance
Department: suspected fraud, waste, and abuse (FWA), potential
health privacy violation, and unethical behavior/employee
misconduct.
a) True
b) False
Correct Answer: a (True)
