Regulations which apply to any claim for an item or service that was not provided as claimed
or that was knowingly submitted as false and which provides guidelines for levying of fines
for such offenses.
A. Health Insurance Portability and Accountability Act (HIPAA)
B. Civil Monetary Penalties Law
C. Anti - Kickback Law
D. Exclusion Staute - ANSWER B. Civil Monetary Penalties Law
The affirmation by signature, usually on a printed form, that the action outlined has been ac-
complished by the individual signing; e.g., the individual has read the code of conduct and
agreed to adhere to its principles.
A. Treatment
B. Attestation
C. Self - Reporting
D. Safe - Harbors - ANSWER B. Attestation
the provision, coordination, or management of health care and related services by one or
more health care providers,
A. Benchmarking
B. Disclosure
C. Attestation
D. Treatment - ANSWER D. treatment
Omnibus Budget Reconciliation Act of 1989 (OBRA) bans physicians from referring 10 desig-
nated health care services to any entity with which physician has a financial relationship.
1
,A. Health Insurance Portability and Accountability Act (HIPAA)
B. Self - referral statute, Stark Law
C. Corporate Integrity Agreement (CIA)
D. False Claims Act (FCA) - ANSWER B. Self - referral statute, Stark Law
Explicit regulatory exceptions to otherwise legally prohibited conduct. Federal safe harbor
regulations specify certain joint ventures and other arrangements concerning hospitals
and/or physicians which do not violate medicare fraud and abuse laws.
A. Attestation
B. Health Care Clearinghouse
C. Health Care Provider
D. Safe Harbors - ANSWER D. Safe Harbors
A coder who has satisfied certification requirements as established by the American Acad-
emy of Professional Coders
A. Health Care Operations pt 6
B. Certified Professional Coder (CPC)
C. Federal Sentencing Guidelines
D. Equal Employee Opportunity Commission (EEOC) - ANSWER B. Certified Professional
Coder (CPC)
Healthcare Fraud Prevention and Enforcement Action Team
A. HEAT
B. HHS
C. Health Care
D. Treatment - ANSWER A. HEAT
employees, volunteers, trainees, etc who conduct in the performance of work for the cov-
ered entity
2
, A. Benchmarking
B. Best practices
C. Workforce
D. Health Care Provider - ANSWER C. Workforce
Publication of the American Medical Association containing the HIPAA-mandated standard-
ized classification system for reporting medical procedures and services performed by physi-
cians.
A. Current Procedural Terminology (CPT)
B. Health Care Compliance Association (HCCA)
C. Occupational Safety and Health Administration (OSHA)
D. Protected Health Information (PHI) - ANSWER A. Current Procedural Terminology (CPT)
1. established standards and procedures2. high-level individual must be charged with com-
pliance3. do not delegate compliance responsibilities to individual with propensity to engage
in illegal activities4. communicate standards and procedures effe
A. Seven Elements of a compliance program
B. Balanced budget act of 1997
C. General services administration (GSA)
D. Exclusion statute - ANSWER A. Seven elements of a compliance program
federal agency that manages the federal government's property and records, including con-
struction of and operation of buildings and procurement and distribution of supplies
A. Equal Employee Opportunity Commission (EEOC)
B. General Services Administration (GSA)
C. Certified Professional Coder (CPC)
D. Federal Sentencing Guidelines - ANSWER B. General Services Administration (GSA)
3
or that was knowingly submitted as false and which provides guidelines for levying of fines
for such offenses.
A. Health Insurance Portability and Accountability Act (HIPAA)
B. Civil Monetary Penalties Law
C. Anti - Kickback Law
D. Exclusion Staute - ANSWER B. Civil Monetary Penalties Law
The affirmation by signature, usually on a printed form, that the action outlined has been ac-
complished by the individual signing; e.g., the individual has read the code of conduct and
agreed to adhere to its principles.
A. Treatment
B. Attestation
C. Self - Reporting
D. Safe - Harbors - ANSWER B. Attestation
the provision, coordination, or management of health care and related services by one or
more health care providers,
A. Benchmarking
B. Disclosure
C. Attestation
D. Treatment - ANSWER D. treatment
Omnibus Budget Reconciliation Act of 1989 (OBRA) bans physicians from referring 10 desig-
nated health care services to any entity with which physician has a financial relationship.
1
,A. Health Insurance Portability and Accountability Act (HIPAA)
B. Self - referral statute, Stark Law
C. Corporate Integrity Agreement (CIA)
D. False Claims Act (FCA) - ANSWER B. Self - referral statute, Stark Law
Explicit regulatory exceptions to otherwise legally prohibited conduct. Federal safe harbor
regulations specify certain joint ventures and other arrangements concerning hospitals
and/or physicians which do not violate medicare fraud and abuse laws.
A. Attestation
B. Health Care Clearinghouse
C. Health Care Provider
D. Safe Harbors - ANSWER D. Safe Harbors
A coder who has satisfied certification requirements as established by the American Acad-
emy of Professional Coders
A. Health Care Operations pt 6
B. Certified Professional Coder (CPC)
C. Federal Sentencing Guidelines
D. Equal Employee Opportunity Commission (EEOC) - ANSWER B. Certified Professional
Coder (CPC)
Healthcare Fraud Prevention and Enforcement Action Team
A. HEAT
B. HHS
C. Health Care
D. Treatment - ANSWER A. HEAT
employees, volunteers, trainees, etc who conduct in the performance of work for the cov-
ered entity
2
, A. Benchmarking
B. Best practices
C. Workforce
D. Health Care Provider - ANSWER C. Workforce
Publication of the American Medical Association containing the HIPAA-mandated standard-
ized classification system for reporting medical procedures and services performed by physi-
cians.
A. Current Procedural Terminology (CPT)
B. Health Care Compliance Association (HCCA)
C. Occupational Safety and Health Administration (OSHA)
D. Protected Health Information (PHI) - ANSWER A. Current Procedural Terminology (CPT)
1. established standards and procedures2. high-level individual must be charged with com-
pliance3. do not delegate compliance responsibilities to individual with propensity to engage
in illegal activities4. communicate standards and procedures effe
A. Seven Elements of a compliance program
B. Balanced budget act of 1997
C. General services administration (GSA)
D. Exclusion statute - ANSWER A. Seven elements of a compliance program
federal agency that manages the federal government's property and records, including con-
struction of and operation of buildings and procurement and distribution of supplies
A. Equal Employee Opportunity Commission (EEOC)
B. General Services Administration (GSA)
C. Certified Professional Coder (CPC)
D. Federal Sentencing Guidelines - ANSWER B. General Services Administration (GSA)
3
