Page | 1
CPCO EXAM Questions and Verified Answers
Question 1
Under Public Law 104-191, the Health Insurance Portability and Accountability
Act of 1996 (HIPAA), what is the name of the national program designed to
coordinate Federal, State and local law enforcement activities with respect to
health care fraud and abuse?
Ans: Health Care Fraud and Abuse Control Program (HCFAC)
Question 2
According to the Federal Sentencing Guidelines, "To have an effective
compliance and ethics program..., an organization shall exercise due diligence to
prevent and detect criminal conduct." The FSGs also state organizations shall:
Ans: Promote an organizational culture that encourages ethical conduct
and a commitment to compliance with the law.
Question 3
If a physician practice uses another entity's standards of conduct, the practice
must:
Ans: Tailor those materials to the physician practice where they will be
applied.
Question 4
As the compliance contact for your physician practice, you are charged with
developing the policies and procedures related to coding and billing. When
developing these policies and procedures, which of the following statements
should be included?
Ans: For any services billed, documentation must be present in the
patient's medical record to support the services.
Question 5
City Orthopedics, a large physician group practice employs several physician
assistants and nurse practitioners. There have been several questions by the
physicians on how incident to services should be billed. The compliance officer
has called the Medicare Administrative Contractor for the practice and was given
some information on how incident to services should be billed. Because the
practice will be relying on the information received from the Medicare
, Page | 2
Administrative Contractor, what steps should the compliance officer take at the
conclusion of the call according to the OIG Compliance Guidance for Individual
and Small Group Physician Practices?
Ans: Document the conversation and retain the records.
Question 6
Developing effective compliance policies and procedures is an important part of
any compliance program. To help your practice mitigate compliance risk,
policies and procedures should:
Ans: Be sure any time frames or requirements listed can be accomplished
given the practice's resources.
Question 7
Select the best phrase from the list below to complete the following policy
statement: Centennial Medical Associates is committed to following Federal,
State, and Local laws, rules, guidelines, and regulations. To promote this effort,
Centennial Medical Associates will perform claims audits at least on an annual
basis to ____________________.
Ans: Verify accuracy of coding and reimbursement for the services
performed.
Question 8
You have just been identified as the compliance officer at your practice. The OIG
Compliance Guidance for Individual and Small Group Physician Practices
suggests six specific duties that may be assigned to you. What is one of those
duties?
Ans: Reviewing reports to see that new employees and vendors have been
checked against the OIG's list of excluded individuals and entities.
Question 9
For larger physician practices, how frequently does the OIG recommend
reporting compliance activities to the Board of Directors and CEO?
Ans: Regularly
Question 10
When conducting compliance training within a physician practice, what is one of
the goals that the practice should strive for in this compliance training?
CPCO EXAM Questions and Verified Answers
Question 1
Under Public Law 104-191, the Health Insurance Portability and Accountability
Act of 1996 (HIPAA), what is the name of the national program designed to
coordinate Federal, State and local law enforcement activities with respect to
health care fraud and abuse?
Ans: Health Care Fraud and Abuse Control Program (HCFAC)
Question 2
According to the Federal Sentencing Guidelines, "To have an effective
compliance and ethics program..., an organization shall exercise due diligence to
prevent and detect criminal conduct." The FSGs also state organizations shall:
Ans: Promote an organizational culture that encourages ethical conduct
and a commitment to compliance with the law.
Question 3
If a physician practice uses another entity's standards of conduct, the practice
must:
Ans: Tailor those materials to the physician practice where they will be
applied.
Question 4
As the compliance contact for your physician practice, you are charged with
developing the policies and procedures related to coding and billing. When
developing these policies and procedures, which of the following statements
should be included?
Ans: For any services billed, documentation must be present in the
patient's medical record to support the services.
Question 5
City Orthopedics, a large physician group practice employs several physician
assistants and nurse practitioners. There have been several questions by the
physicians on how incident to services should be billed. The compliance officer
has called the Medicare Administrative Contractor for the practice and was given
some information on how incident to services should be billed. Because the
practice will be relying on the information received from the Medicare
, Page | 2
Administrative Contractor, what steps should the compliance officer take at the
conclusion of the call according to the OIG Compliance Guidance for Individual
and Small Group Physician Practices?
Ans: Document the conversation and retain the records.
Question 6
Developing effective compliance policies and procedures is an important part of
any compliance program. To help your practice mitigate compliance risk,
policies and procedures should:
Ans: Be sure any time frames or requirements listed can be accomplished
given the practice's resources.
Question 7
Select the best phrase from the list below to complete the following policy
statement: Centennial Medical Associates is committed to following Federal,
State, and Local laws, rules, guidelines, and regulations. To promote this effort,
Centennial Medical Associates will perform claims audits at least on an annual
basis to ____________________.
Ans: Verify accuracy of coding and reimbursement for the services
performed.
Question 8
You have just been identified as the compliance officer at your practice. The OIG
Compliance Guidance for Individual and Small Group Physician Practices
suggests six specific duties that may be assigned to you. What is one of those
duties?
Ans: Reviewing reports to see that new employees and vendors have been
checked against the OIG's list of excluded individuals and entities.
Question 9
For larger physician practices, how frequently does the OIG recommend
reporting compliance activities to the Board of Directors and CEO?
Ans: Regularly
Question 10
When conducting compliance training within a physician practice, what is one of
the goals that the practice should strive for in this compliance training?
