CHC Exam |Study Questions and Verified
Answers| 100% Correct (2023/ 2024)
QUESTION
Examples of "outliers" that OIG might identify in certain hospital relationships or arrangements
with greatest risk of non-compliance:
a. audit processes that includes e-visits, interviews, trend analysis, etc.
b. medical office building leases consistent with fair market value
c. large and inconsistent payments made to physicians without a written contract
d. none of the above
Answer:
c. large and inconsistent payments made to physicians without a written contract
QUESTION
The PhRMA Code prohibits which of the following:
a. Pharmaceutical companies that bring free lunches to a healthcare organization weekly to
promote the use of their product
b. Pharmaceutical companies paying for trip expenses and stipend for a physician to come and
speak at conference because he prescribes their product often and has had much success treating
his patients with it
c. Pharmaceutical companies providing lunches to the providers and their wives, while providing
an educational session about a particular new drug
d. All of the above
e. None of the above
Answer:
d. All of the above
See the most updated PhRMA Code of Interactions: https://www.phrma.org/-
/media/Project/PhRMA/PhRMA-Org/PhRMA-Org/PDF/A-C/Code-of-Interaction_FINAL21.pdf
QUESTION
,An employee responsible for quality assurance reviews was terminated for inappropriately
accessing sensitive information of a health plan beneficiary. The employee appealed the
decision, stating a colleague received a verbal warning for similar conduct just last month.
Which of the following is the responsibility of the privacy official?
a. Endure disciplinary action is imposed
b. Develop corrective action for each disciplined employee
c. Monitor disciplinary action consistently
d. Document disciplinary action for all substantiated complaints
Answer:
c. Monitor disciplinary action consistently
QUESTION
What are the four impermissible (HIPAA breach)?
Answer:
Access
Acquisition
Use
Disclosure
QUESTION
An agency investigating a complaint of a HIPAA privacy violation contacts the facility for
patient information. The facility's policy should be to disclose all information:
a. If a search warrant is presented
b. That is required by state law
c. If the patients have been informed
d. Requested except for PHI
Answer:
b. That is required by state law
QUESTION
Fill in the blank:
,The ___________ ____ Act further required that the HHS Secretary, in consultation with HHS-
OIG, establish "core elements" for provider and supplier compliance programs within a
particular industry or sector.
Answer:
Affordable Care
Pursuant to 42 C.F.R. §§ 422.503(b)(4)(vi), 423.504(b)(4)(vi), and as incorporated into Chapter
21, Section 30 of the "Medicare Managed Care Manual":
All sponsors are required to adopt and implement an effective compliance program, which must
include measures to prevent, detect and correct Part C or D program noncompliance as well as
FWA. The compliance program must, at a minimum, include the following core requirements: 1.
Written Policies, Procedures and Standards of Conduct; 2. Compliance Officer, Compliance
Committee and High Level Oversight; 3. Effective Training and Education; 4. Effective Lines of
Communication; 5. Well Publicized Disciplinary Standards; 6. Effective System for Routine
Monitoring and Identification of Compliance Risks; and 7. Procedures and System for Prompt
Response to Compliance Issues.
These seven elements are functionally equivalent to the seven elements of an effective
compliance plan identified by HHS-OIG in its publication, Compliance Program for Individual
and Small Group Physician Practices.
QUESTION
Fill in the blanks:
The OIG CPG states: Standards of _______ should articulate hospital's commitment to comply
with Federal and state standards..... they should state the organization's mission, goals, and
ethical requirements of compliance and reflect a carefully crafted, clear expression of
expectations for all hospital governing body members, officers, managers, employees,
physicians, and, where appropriate, _______ and other agents.
Answer:
conduct;
contractors
QUESTION
You are the new Compliance Officer, hired after ABC Hospital reorganized and decided that the
General Counsel should no longer also serve in that role. Upon review of the Code of Conduct
(CoC), you find that it is written using lots of legal jargon. What action do you take:
a. Keep CoC as it is.
b. Pull a sample off the internet and insert hospital name to save time as it was most likely
written by experts.
, c. Rewrite the CoC in plain and concise language tailored to the hospital so employees can use a
general guidance.
d. Rewrite the CoC with detailed restating hospital's P&Ps, and all laws and regulations possible
so that employees can't say they were not aware of requirements.
Answer:
c. Rewrite the CoC in plain and concise language tailored to the hospital so employees can use a
general guidance.
Explanation:
CoC should be clear and concise language easy to understand, and should be tailored to specific
issues of the organization
QUESTION
What should CCO be able to do? (What skills should this person have?) Choose all that apply.
a. Leadership skills.
b. Oversee the coding department.
c. Skills to design and implement a compliance program.
d. Be able to anticipate new risk areas.
e. Practical experience with documenting medical necessity.
Answer:
a. c. and d.
QUESTION
Life cycle of records management
Answer:
Creation
Use
Maintenance
Retention
Disposition
QUESTION
New Employee Policy - three checks OIG recommends to do/perform:
Answers| 100% Correct (2023/ 2024)
QUESTION
Examples of "outliers" that OIG might identify in certain hospital relationships or arrangements
with greatest risk of non-compliance:
a. audit processes that includes e-visits, interviews, trend analysis, etc.
b. medical office building leases consistent with fair market value
c. large and inconsistent payments made to physicians without a written contract
d. none of the above
Answer:
c. large and inconsistent payments made to physicians without a written contract
QUESTION
The PhRMA Code prohibits which of the following:
a. Pharmaceutical companies that bring free lunches to a healthcare organization weekly to
promote the use of their product
b. Pharmaceutical companies paying for trip expenses and stipend for a physician to come and
speak at conference because he prescribes their product often and has had much success treating
his patients with it
c. Pharmaceutical companies providing lunches to the providers and their wives, while providing
an educational session about a particular new drug
d. All of the above
e. None of the above
Answer:
d. All of the above
See the most updated PhRMA Code of Interactions: https://www.phrma.org/-
/media/Project/PhRMA/PhRMA-Org/PhRMA-Org/PDF/A-C/Code-of-Interaction_FINAL21.pdf
QUESTION
,An employee responsible for quality assurance reviews was terminated for inappropriately
accessing sensitive information of a health plan beneficiary. The employee appealed the
decision, stating a colleague received a verbal warning for similar conduct just last month.
Which of the following is the responsibility of the privacy official?
a. Endure disciplinary action is imposed
b. Develop corrective action for each disciplined employee
c. Monitor disciplinary action consistently
d. Document disciplinary action for all substantiated complaints
Answer:
c. Monitor disciplinary action consistently
QUESTION
What are the four impermissible (HIPAA breach)?
Answer:
Access
Acquisition
Use
Disclosure
QUESTION
An agency investigating a complaint of a HIPAA privacy violation contacts the facility for
patient information. The facility's policy should be to disclose all information:
a. If a search warrant is presented
b. That is required by state law
c. If the patients have been informed
d. Requested except for PHI
Answer:
b. That is required by state law
QUESTION
Fill in the blank:
,The ___________ ____ Act further required that the HHS Secretary, in consultation with HHS-
OIG, establish "core elements" for provider and supplier compliance programs within a
particular industry or sector.
Answer:
Affordable Care
Pursuant to 42 C.F.R. §§ 422.503(b)(4)(vi), 423.504(b)(4)(vi), and as incorporated into Chapter
21, Section 30 of the "Medicare Managed Care Manual":
All sponsors are required to adopt and implement an effective compliance program, which must
include measures to prevent, detect and correct Part C or D program noncompliance as well as
FWA. The compliance program must, at a minimum, include the following core requirements: 1.
Written Policies, Procedures and Standards of Conduct; 2. Compliance Officer, Compliance
Committee and High Level Oversight; 3. Effective Training and Education; 4. Effective Lines of
Communication; 5. Well Publicized Disciplinary Standards; 6. Effective System for Routine
Monitoring and Identification of Compliance Risks; and 7. Procedures and System for Prompt
Response to Compliance Issues.
These seven elements are functionally equivalent to the seven elements of an effective
compliance plan identified by HHS-OIG in its publication, Compliance Program for Individual
and Small Group Physician Practices.
QUESTION
Fill in the blanks:
The OIG CPG states: Standards of _______ should articulate hospital's commitment to comply
with Federal and state standards..... they should state the organization's mission, goals, and
ethical requirements of compliance and reflect a carefully crafted, clear expression of
expectations for all hospital governing body members, officers, managers, employees,
physicians, and, where appropriate, _______ and other agents.
Answer:
conduct;
contractors
QUESTION
You are the new Compliance Officer, hired after ABC Hospital reorganized and decided that the
General Counsel should no longer also serve in that role. Upon review of the Code of Conduct
(CoC), you find that it is written using lots of legal jargon. What action do you take:
a. Keep CoC as it is.
b. Pull a sample off the internet and insert hospital name to save time as it was most likely
written by experts.
, c. Rewrite the CoC in plain and concise language tailored to the hospital so employees can use a
general guidance.
d. Rewrite the CoC with detailed restating hospital's P&Ps, and all laws and regulations possible
so that employees can't say they were not aware of requirements.
Answer:
c. Rewrite the CoC in plain and concise language tailored to the hospital so employees can use a
general guidance.
Explanation:
CoC should be clear and concise language easy to understand, and should be tailored to specific
issues of the organization
QUESTION
What should CCO be able to do? (What skills should this person have?) Choose all that apply.
a. Leadership skills.
b. Oversee the coding department.
c. Skills to design and implement a compliance program.
d. Be able to anticipate new risk areas.
e. Practical experience with documenting medical necessity.
Answer:
a. c. and d.
QUESTION
Life cycle of records management
Answer:
Creation
Use
Maintenance
Retention
Disposition
QUESTION
New Employee Policy - three checks OIG recommends to do/perform:
