CPCO Chapter 3 Review Exam With Questions
And Answers Graded A+
When a compliance program is established, the OIG recommends that a billing
company, takes a ___________________ of the Company's operations. - Answer
Snapshot
Response Feedback:
Rationale: The snapshot will let the company know where the organization is with their
compliance and what their risk areas are.
There has been an increased national focus on ____________. - Answer Quality of
health care
Response Feedback:
The trend away from a departmental focus and toward "patient-focused" care in
hospitals and physician practices has been emerging. There is currently a national
focus on the quality of care a patient receives while being treated.
The _______________addresses compliance concerns, such as compensation paid by
laboratories to referring physicians and physician group practices for blood specimen
collection, processing and packaging and for submitting patient data to registry or
database. - Answer Special Fraud Alert
Response Feedback:
The OIG has designed and issued special fraud alerts to the health care provider
community for the last 20 years.
Joan is the CO for ABC Provider Group. One of her providers asks her which Federal
agency provides compliance program guidance to providers and covered entities? Joan
tells the provider: - Answer Office of Inspector General
Response Feedback:
The OIG has been providing compliance program guidelines since 1998.
Federal regulations pertinent to billing companies include all except: - Answer Safe
Harbor Rules for Billing Companies
Response Feedback:
, The "safe harbor" regulations describe various payment and business practices that,
although they potentially implicate the Federal anti-kickback statute, are not treated as
offenses under the statute.
Laura is the CPCO for Angel Nursing home. She is explaining to the staff why is it
important for nursing facilities to track patient outcomes. She states this is to: - Answer
accomplish compliance
Response Feedback:
Nursing Facilities can accomplish compliance through development of protocols and
through a system that reviews and analyzes each patient's/resident's outcomes with the
protocols.
The OlG Work Plan includes projects to be addressed during the fiscal year (and
beyond) by the all of the following EXCEPT: - Answer Office of HHS
Response Feedback:
The OIG Work Plan includes projects to be addressed during the fiscal year (and
beyond) by the Office of Audit Services, Office of Evaluation and Inspections, Office of
Investigations, and Office of Counsel to the Inspector General. The entire current Work
Plan or sections of the plan can be downloaded at the OIG's website at
https://oig.hhs.gov/reports-and-publications/workplan/.
What can result in imprisonment and penalties for providers and covered entities? -
Answer Medical fraud
Response Feedback:
Medical fraud is a federal crime that is costly and, when committed, can result in
financial penalties and jail time. The difference between fraud and abuse is "intent."
Anti-dumping statues, 42 U.S.C. 1395dd, require a hospital to do all of the following
EXCEPT? - Answer Transfer to another hospital if emergency room is busy
Response Feedback:
The statute requires all hospitals that participate with Medicare follow the patient
dumping rules. There are strict rules about what must be done before a patient can be
transferred.
What will show a third party that they have good faith towards remediation? - Answer
Prompt reporting
Response Feedback:
By promptly reporting any wrongdoings a third party shows good faith and willingness to
work with governmental authorities to correct and remedy the problem.
And Answers Graded A+
When a compliance program is established, the OIG recommends that a billing
company, takes a ___________________ of the Company's operations. - Answer
Snapshot
Response Feedback:
Rationale: The snapshot will let the company know where the organization is with their
compliance and what their risk areas are.
There has been an increased national focus on ____________. - Answer Quality of
health care
Response Feedback:
The trend away from a departmental focus and toward "patient-focused" care in
hospitals and physician practices has been emerging. There is currently a national
focus on the quality of care a patient receives while being treated.
The _______________addresses compliance concerns, such as compensation paid by
laboratories to referring physicians and physician group practices for blood specimen
collection, processing and packaging and for submitting patient data to registry or
database. - Answer Special Fraud Alert
Response Feedback:
The OIG has designed and issued special fraud alerts to the health care provider
community for the last 20 years.
Joan is the CO for ABC Provider Group. One of her providers asks her which Federal
agency provides compliance program guidance to providers and covered entities? Joan
tells the provider: - Answer Office of Inspector General
Response Feedback:
The OIG has been providing compliance program guidelines since 1998.
Federal regulations pertinent to billing companies include all except: - Answer Safe
Harbor Rules for Billing Companies
Response Feedback:
, The "safe harbor" regulations describe various payment and business practices that,
although they potentially implicate the Federal anti-kickback statute, are not treated as
offenses under the statute.
Laura is the CPCO for Angel Nursing home. She is explaining to the staff why is it
important for nursing facilities to track patient outcomes. She states this is to: - Answer
accomplish compliance
Response Feedback:
Nursing Facilities can accomplish compliance through development of protocols and
through a system that reviews and analyzes each patient's/resident's outcomes with the
protocols.
The OlG Work Plan includes projects to be addressed during the fiscal year (and
beyond) by the all of the following EXCEPT: - Answer Office of HHS
Response Feedback:
The OIG Work Plan includes projects to be addressed during the fiscal year (and
beyond) by the Office of Audit Services, Office of Evaluation and Inspections, Office of
Investigations, and Office of Counsel to the Inspector General. The entire current Work
Plan or sections of the plan can be downloaded at the OIG's website at
https://oig.hhs.gov/reports-and-publications/workplan/.
What can result in imprisonment and penalties for providers and covered entities? -
Answer Medical fraud
Response Feedback:
Medical fraud is a federal crime that is costly and, when committed, can result in
financial penalties and jail time. The difference between fraud and abuse is "intent."
Anti-dumping statues, 42 U.S.C. 1395dd, require a hospital to do all of the following
EXCEPT? - Answer Transfer to another hospital if emergency room is busy
Response Feedback:
The statute requires all hospitals that participate with Medicare follow the patient
dumping rules. There are strict rules about what must be done before a patient can be
transferred.
What will show a third party that they have good faith towards remediation? - Answer
Prompt reporting
Response Feedback:
By promptly reporting any wrongdoings a third party shows good faith and willingness to
work with governmental authorities to correct and remedy the problem.
