HCCA - CHC STUDY QUESTIONS (MASTER
FLASHCARDS) NEW MODIFIED QUESTIONS
WITH VERIFIED ANSWERS
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. --CORRECT ANSWER--a. Compliance
programs are considered more dangerous if they are developed but not implemented.
An individual's understanding of the compliance aspects of their job can BEST be enhanced
by including compliance in:
a. annual evaluations
b. exit interviews
c. HR benefit materials
d. audit committee meetings --CORRECT ANSWER--a. annual evaluations
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
Page 1 of 232
,c. Policy document
d. Legal standards --CORRECT ANSWER--c. Policy document
CAP - outlines corrective action plan
Procedure - describes process/steps under a certain criteria
Legal standards - mandatory action or rule
Life cycle of records management --CORRECT ANSWER--Creation
Use
Maintenance
Retention
Disposition
Standards of Conduct (written P&Ps) --CORRECT 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 --CORRECT 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
Page 2 of 232
,Ref: SCCE Compliance & Ethics Manual, Chapter 2
https://compliancecosmos.org/essential-elements-effective-ethics-and-compliance-program
Code of Conduct and Employees --CORRECT 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
Code of Conduct Purpose --CORRECT 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: --CORRECT ANSWER--• Internal
assessments
• Record retention (where, how long)
• Self-disclosure
• Medicare sanction checks (LEIE)
• Billing policies
Page 3 of 232
, • Credit balance
• No charge visits
• Incomplete/unsuccessful procedure
• Documentation requirements
When should Code of Conduct be distributed to new employees? --CORRECT 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 --CORRECT
ANSWER--a. b. d.
The software can be used by other entities other than hospitals, so option "c." is not precisely
accurate, but it is free to use and can be downloaded here: https://oig.hhs.gov/compliance/rat-
stats/index.asp
What is the term called for an organization's commitment to compliance by management,
employees, and contractors. Statement should summarize ethical behavior and legal
principles under which the healthcare organization operates? --CORRECT ANSWER--Code
of Conduct
In the course of an audit, you find that disciplinary actions against certain physicians and high
level executives for non-compliance in the organization have been unfair and inconsistent
with current policies & procedures. What is your first course of action
Page 4 of 232
FLASHCARDS) NEW MODIFIED QUESTIONS
WITH VERIFIED ANSWERS
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. --CORRECT ANSWER--a. Compliance
programs are considered more dangerous if they are developed but not implemented.
An individual's understanding of the compliance aspects of their job can BEST be enhanced
by including compliance in:
a. annual evaluations
b. exit interviews
c. HR benefit materials
d. audit committee meetings --CORRECT ANSWER--a. annual evaluations
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
Page 1 of 232
,c. Policy document
d. Legal standards --CORRECT ANSWER--c. Policy document
CAP - outlines corrective action plan
Procedure - describes process/steps under a certain criteria
Legal standards - mandatory action or rule
Life cycle of records management --CORRECT ANSWER--Creation
Use
Maintenance
Retention
Disposition
Standards of Conduct (written P&Ps) --CORRECT 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 --CORRECT 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
Page 2 of 232
,Ref: SCCE Compliance & Ethics Manual, Chapter 2
https://compliancecosmos.org/essential-elements-effective-ethics-and-compliance-program
Code of Conduct and Employees --CORRECT 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
Code of Conduct Purpose --CORRECT 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: --CORRECT ANSWER--• Internal
assessments
• Record retention (where, how long)
• Self-disclosure
• Medicare sanction checks (LEIE)
• Billing policies
Page 3 of 232
, • Credit balance
• No charge visits
• Incomplete/unsuccessful procedure
• Documentation requirements
When should Code of Conduct be distributed to new employees? --CORRECT 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 --CORRECT
ANSWER--a. b. d.
The software can be used by other entities other than hospitals, so option "c." is not precisely
accurate, but it is free to use and can be downloaded here: https://oig.hhs.gov/compliance/rat-
stats/index.asp
What is the term called for an organization's commitment to compliance by management,
employees, and contractors. Statement should summarize ethical behavior and legal
principles under which the healthcare organization operates? --CORRECT ANSWER--Code
of Conduct
In the course of an audit, you find that disciplinary actions against certain physicians and high
level executives for non-compliance in the organization have been unfair and inconsistent
with current policies & procedures. What is your first course of action
Page 4 of 232
