HCCA - CHC Study Questions/ Content covers
each compliance program element, HIPAA
terms, compliance related laws & regulations,
study materials, and general definitions and
acronyms
A Compliance Program with well written policies and procedures:
a. can be successful if consistently reviewed and maintained
b. cannot be effective due to the sheer volume presented
c. will be effective if read by management
d. will not be successful without the proper oversight - Answer: d. will not be successful without
the proper oversight
A Compliance Officer can achieve a higher level of compliance and ethics engagement by:
a. ensuring leadership reads the policies
b. increasing management involvement
c. responding to compliance hotline calls
Page 1 of 198
,d. monitoring the code of conduct - Answer: b. increasing management involvement
Which of the following requires providers to be permanently excluded from all federal health
care programs if found guilty of a healthcare related fraud a third time:
a. Deficit Reduction Act of 2005
b. False Claims Act
c. Balance Budget Act of 1997
d. Social Security Act section 1128 - Answer: c. Balance Budget Act of 1997
Also known as a BBA "three strikes rule"
Which statement is TRUE regarding compliance programs?
a. Compliance programs are considered more dangerous if they are developed but not
implemented.
b. Compliance programs can detect but not prevent criminal conduct
c. Compliance programs are only required by law for healthcare entities that have more than
$500,000 in annual revenue.
d. Compliance programs are not mandated by law. - Answer: a. Compliance programs are
considered more dangerous if they are developed but not implemented.
Formal statement outlining a plan for a specified subject area. It usually cites state and/or
federal required actions or standards.
a. CAP
b. Procedure document
c. Policy document
d. Legal standards - Answer: c. Policy document
CAP - outlines corrective action plan
Procedure - describes process/steps under a certain criteria
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,Legal standards - mandatory action or rule
Life cycle of records management - Answer: Creation
Use
Maintenance
Retention
Disposition
Standards of Conduct (written P&Ps) - Answer: Demonstrate the organization's ethical attitude
and its "enterprise-wide" emphasis on compliance with all applicable laws and regulations
Code of Conduct: Content Checklist - Answer: • Demonstrate system wide emphasis on
compliance with all applicable laws and regulations
• Written plainly and concisely so all employees can understand the standards
• Includes internal and external regulations
• Mentions organizational policies without completely restating them
• Is consistent with company policies and procedures
• Includes management's responsibility to explain and enforce the code
Ref: SCCE Compliance & Ethics Manual, Chapter 2
https://compliancecosmos.org/essential-elements-effective-ethics-and-compliance-program
Code of Conduct and Employees - Answer: All employees must receive, read, and understand
the standards.
A supervisor should explain the standards and answer any questions.
Employee should attest in writing that they have received, read, and understood the standards
Employee compliance with standards must be enforced through appropriate discipline when
necessary
Discipline for non-compliance should be stated in the standards
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, Code of Conduct Purpose - Answer: • To present specific guidelines for employees to follow
• To confirm that all employees comprehend what is required of them
• To provide a process for proper decision making
• To confirm that employees put standards into everyday practice
• To elevate corporate performance in basic business relationship
• To confirm that the organization upholds and supports proper compliance conduct
Every organization needs policies and procedures for: - Answer: • Internal assessments
• Record retention (where, how long)
• Self-disclosure
• Medicare sanction checks (LEIE)
• Billing policies
• Credit balance
• No charge visits
• Incomplete/unsuccessful procedure
• Documentation requirements
When should Code of Conduct be distributed to new employees? - Answer: Must be distributed
within 90 days of hire
RAT-STATS is: (select all that apply)
a. statistical software to select randomized samples
b. government statistical rule software developed in the 1970s
c. free hospital statistical software
d. recommended by OIG, CMS and other agencies to select random samples - Answer: a. b. d.
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each compliance program element, HIPAA
terms, compliance related laws & regulations,
study materials, and general definitions and
acronyms
A Compliance Program with well written policies and procedures:
a. can be successful if consistently reviewed and maintained
b. cannot be effective due to the sheer volume presented
c. will be effective if read by management
d. will not be successful without the proper oversight - Answer: d. will not be successful without
the proper oversight
A Compliance Officer can achieve a higher level of compliance and ethics engagement by:
a. ensuring leadership reads the policies
b. increasing management involvement
c. responding to compliance hotline calls
Page 1 of 198
,d. monitoring the code of conduct - Answer: b. increasing management involvement
Which of the following requires providers to be permanently excluded from all federal health
care programs if found guilty of a healthcare related fraud a third time:
a. Deficit Reduction Act of 2005
b. False Claims Act
c. Balance Budget Act of 1997
d. Social Security Act section 1128 - Answer: c. Balance Budget Act of 1997
Also known as a BBA "three strikes rule"
Which statement is TRUE regarding compliance programs?
a. Compliance programs are considered more dangerous if they are developed but not
implemented.
b. Compliance programs can detect but not prevent criminal conduct
c. Compliance programs are only required by law for healthcare entities that have more than
$500,000 in annual revenue.
d. Compliance programs are not mandated by law. - Answer: a. Compliance programs are
considered more dangerous if they are developed but not implemented.
Formal statement outlining a plan for a specified subject area. It usually cites state and/or
federal required actions or standards.
a. CAP
b. Procedure document
c. Policy document
d. Legal standards - Answer: c. Policy document
CAP - outlines corrective action plan
Procedure - describes process/steps under a certain criteria
Page 2 of 198
,Legal standards - mandatory action or rule
Life cycle of records management - Answer: Creation
Use
Maintenance
Retention
Disposition
Standards of Conduct (written P&Ps) - Answer: Demonstrate the organization's ethical attitude
and its "enterprise-wide" emphasis on compliance with all applicable laws and regulations
Code of Conduct: Content Checklist - Answer: • Demonstrate system wide emphasis on
compliance with all applicable laws and regulations
• Written plainly and concisely so all employees can understand the standards
• Includes internal and external regulations
• Mentions organizational policies without completely restating them
• Is consistent with company policies and procedures
• Includes management's responsibility to explain and enforce the code
Ref: SCCE Compliance & Ethics Manual, Chapter 2
https://compliancecosmos.org/essential-elements-effective-ethics-and-compliance-program
Code of Conduct and Employees - Answer: All employees must receive, read, and understand
the standards.
A supervisor should explain the standards and answer any questions.
Employee should attest in writing that they have received, read, and understood the standards
Employee compliance with standards must be enforced through appropriate discipline when
necessary
Discipline for non-compliance should be stated in the standards
Page 3 of 198
, Code of Conduct Purpose - Answer: • To present specific guidelines for employees to follow
• To confirm that all employees comprehend what is required of them
• To provide a process for proper decision making
• To confirm that employees put standards into everyday practice
• To elevate corporate performance in basic business relationship
• To confirm that the organization upholds and supports proper compliance conduct
Every organization needs policies and procedures for: - Answer: • Internal assessments
• Record retention (where, how long)
• Self-disclosure
• Medicare sanction checks (LEIE)
• Billing policies
• Credit balance
• No charge visits
• Incomplete/unsuccessful procedure
• Documentation requirements
When should Code of Conduct be distributed to new employees? - Answer: Must be distributed
within 90 days of hire
RAT-STATS is: (select all that apply)
a. statistical software to select randomized samples
b. government statistical rule software developed in the 1970s
c. free hospital statistical software
d. recommended by OIG, CMS and other agencies to select random samples - Answer: a. b. d.
Page 4 of 198
