Passed
You are the new compliance officer for a hospital and see that it is currently under an OIG CIA.
What would be the first course of action in your new position?
a. Review the current OIG Work Plan and update the audit schedule for the hospital.
b. Review the Code of Conduct and Policies and Procedures and update them as appropriate.
c. Meet with the Compliance Board and discuss your vision of how compliance will be run in the
future.
d. Review the audit schedule and pick up where the previous compliance officer left off. ✔✔b.
Review the Code of Conduct and Policies and Procedures and update them as appropriate
When developing an effective code of conduct, an organization should consider:
a. Soliciting another organization's code and tweaking it to fit
b. Methods for reporting issues
c. Zero tolerance for fraud and abuse
d. B and C ✔✔d. B and C
The compliance officer has completed the non-retaliation policy and it's been officially
implemented. The next steps should be:
,a. Investigate all reports of violations
b. Post the information publicly in the internet
c. Make the information available to hospital employees
d. Revise it annually ✔✔c. Make the information available to hospital employees
A Principal Investigator is accused of accepting kickbacks from a sponsor. The allegation is that
the study budget included an item for funds to cover office visits required by the study, but all
the office visits have been billed to insurance as "standard of care." A research compliance
professional should FIRST notify the:
a. IRB to request initiation of an investigation
b. sponsor to inform that funds may have been inappropriately diverted
c. BOD to request that study-related billing be suspended
d. legal office to determine if an investigation should be conducted under privilege ✔✔d. legal
office to determine if an investigation should be conducted under privilege
Quitam actions enable any person to bring forth an action to the
a. employer, based upon original knowledge
b. employer, based upon public information
c. government, based upon public knowledge
,d. government, based upon original information ✔✔d. government, based upon original
information
The annual OIG work plan is a document that outlines the OIG's annual:
a. staffing needs
b. budget plans
c. investigation ideas
d. education agenda ✔✔c. investigation ideas
TRUE or FALSE: As a CO, you are tasked with identifying risk. Knowing some document
reviews may never apply to your organization, should you review Special Advisory Bulletins?
✔✔TRUE
There are many benefits of having an effective compliance program. Which, of the below, is one
such benefit?
a. It shows that the practice is making a good faith effort to be compliant.
b. It provides a means to cover errors until they can be fixed.
c. It allows employees to retaliate against their employer when they believe they have been
treated unfairly.
, d. It provides a basis for the OIG to create a CIA if a problem is identified. ✔✔a. It shows that
the practice is making a good faith effort to be compliant.
Note: practice question from AAPC CPCO Ch2
What term would be used for actions that, either directly or indirectly, results in unnecessary
costs to the Medicare program, for instance, improper payments for services not medically
necessary?
a. Fraud
b. Mistake
c. Waste
d. Abuse ✔✔d. Abuse
Abuse - Similar to Fraud, but the difference between fraud and abuse is the individual's intent to
deceive or misrepresent
Fraud - knowingly/intentionally
Waste - misuse/overuse of resources
Note: practice question from AAPC CPCO Ch1