Studienführer, Klassennotizen & Zusammenfassungen

CPCO Exam Prep | 36 Questions and Answers 100% Solved Which Act of 2003 gave momentum to the e-prescribing movement, and was put in place to reduce medication errors due to illegible physician handwriting, etc.? - Medicare Modernization Act (MMA) The CMP Inflation Adjustment increased the maximum penalty amount per false claim to? - 10,781-$21,563, plus the assessment of not more than three times the amount claimed for damages In a qui tam action in which the government intervenes,...

How many regions are part of the Medicaid Fraud Control Unit? 3 6 9 12 - ANSWER-6 Regions are located in: Northeastern Region; Eastern Region; Southern Region; Midwestern Region; Central Region; and Western Region. What description below best describes ZPICs? ZPICs are federal companies contracted by CMS, used to conduct audits for Medicare and Medicaid overpayments ZPICs are state companies contracted by CMS, used to conduct audits for Medicare and Medicaid overpayments ZPICs are pri...

Kim, Compliance Officer at Apple Rural Health, explains to the HR Manager that both of there departments should offer _______means of communication to help resolve communication issues. - ANSWER-multiple Response Feedback: Poor communication is often the impetus for both human resources and compliance issues. Compliance and human resources personnel should provide employees with multiple means and opportunities to communicate John, Compliance Officer for ABC Internal Medicine Group, expl...

The Office of Inspector General (OIG) works from within what organization to identify vulnerabilities in the health care system? - ANSWER-HHS Response Feedback: The Office of Inspector General (OIG) works from within HHS to identify vulnerabilities in the health care system to offer compliance guidance to health care facilities and professionals, and to promote accountability and enforce regulation. Which type of fraud covers any criminal fraudulent activity that has been determined to h...

Dr. Smith had some billing issues at his medical office. He agreed to work with the OIG to correct the issues. What does the term "CCA" refer to so that you (the Compliance Officer) can explain to Dr. Smith? - ANSWER-Certification of Compliance Agreement in which providers agree to continue to operate their existing compliance program. Response Feedback: CCA is a Certification of Compliance Agreement which requires providers to certify they will continue to operate their existing complianc...

What are designated health services? - ANSWER-• Clinical laboratory services • Physical therapy services • Radiology services, including magnetic resonance imaging, computerized axial tomography scans, and ultrasound services • Radiation therapy services including supplies • Parenteral and enteral nutrients, equipment, and supplies • Prosthetics, orthotics, and prosthetic devices and supplies • Home health services • Outpatient prescription drugs • Inpatient and outpati...

The non-compliance has created a big risk of the group and Kim needs to make sure that everyone knows about the risk of not following the compliance plan. - ANSWER-Kim, Compliance Officer for ABC Provider Group, created a compliance plan and policy a year ago. While reviewing the groups baseline audits, it comes to her attention that many of the staff have decided NOT to follow the compliance plan. Which statement is TRUE regarding this scenario? Levels of non-compliance include (1) intention...

C. Health Care Fraud and Abuse Control Program (HCFAC) - ANSWER-Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, 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? A. Health Care Fraud Prevention and Enforcement Action Team (HEAT) B. Health Care Recovery and Affordable Care Act (HCRAC) C. Health Care Fraud and Abuse Control Program (...

iance certification agreements (CCAs) require providers to certify they will continue to operate their existing compliance program for a fixed term. What is the typical term of a corporate integrity agreement (CIA)? - ANSWER-three years 2.The OIG has stated that an affective compliance plan can help create which of the following? - ANSWER-customer loyalty, community support, and financial success 3.The office for civil rights (OCR) has enforcement power for violations occurring as a result...

Can providers request an extension for providing records requested by an auditor if there is a problem meeting the deadline? - ANSWER-Yes, by calling the requestor and explaining the reason for delay Response Feedback: Rationale: If there is a problem meeting the deadline, call the requestor to explain the reason for the delay and ask for an extension. What established the Medicaid Integrity Program? - ANSWER-Section 1936 of the Social Security Act Response Feedback: Section 1936 of...