HCCA - CHC STUDY QUESTIONS
WITH ACCURATE / VERIFIED
ANSWERS
Terms in this set (781)
True or False: True
The ACA requires that all providers
adopt a compliance plan as a ref. ACA section
6102 condition of enrollment with
Medicare, Medicaid, and Children's
Health Insurance Program (CHIP).
According to HHS-OIG - what are 1.Protect our
programs three important reasons for proper 2.Protect
your patients documentation in Compliance? 3.Protect
the Provider (hint: protections)
https://oig.hhs.gov/newsroom/podcasts/2011/hea
t/heat09-
trans.asp#:~:text=Proper%20documentation%2C%
20both%20in%20patients,to%20protect%20you%
20the%20provider.
,At which level of the Medicare Part c. . third level of
appeal A or Part B appeals process is the
appeal decision by the Office of Frist level - redetermination by Medicare
Medicare Hearings and Appeals contractor
(OMHA)? Second level - reconsideration by Independent
a.first level of appeal contractor
b. second level of appeal Third appeal - Administrative Law Judge (ALJ)
c. third level of appeal hearing
d. fourth level of appeal Fourth appeal - review by Medicare Appeals
Council
Fifth appeal - review in Federal District Court
https://www.hhs.gov/about/agencies/omha/the-
appeals-process/index.html
What should CCO be able to do? a. Leadership skills,
(What skills should this person c. Skills to design and implement a
compliance have?) Choose all that apply. program, and
a.Leadership skills. d. Be able to anticipate new risk areas.
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.
Which of the following is an c. non-retaliation for whistleblowers
absolute necessity in order to have
a successful Compliance Program?
a.continuous training
and improvements
b. effective reporting path
c. non-retaliation for whistleblowers
d. reliable and equal discipline
,A Compliance Program with well d. will not be successful without the proper
written policies and procedures: oversight
a.can be successful if consistently
reviewed and maintained Regardless of having the best written policies in
b. cannot be effective due to the place that are reviewed/maintained consistently,
sheer volume presented and read and disseminated accordingly, will fail
if
c. will be effective if read by there is no proper oversight to ensure they
are management actually being followed and understood.
d. will not be successful without the
proper oversight
A Compliance Officer can achieve a b. increasing management involvement.
higher level of compliance and
ethics engagement by: Compliance is everyone's responsibility, but
a.ensuring leadership reads the management involvement is crucial. They have
a policies direct contact with employees, they know
and
b. increasing management understand their staff's needs and concerns,
and involvement have the most influence over employee's
actions
c. responding to compliance and attitudes. Employees most likely use
their hotline calls direct manager(s) to raise concerns and
the
d. monitoring the code of conduct reason they are so critical for an organization to
foster a culture of compliance.
Which of the following requires c. Balance Budget Act of
1997 providers to be permanently
excluded from all federal health Also known as a BBA "three strikes
rule" 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 1128d
, What section of the ACA prevents b. ACA section 1557 is the correct
answer. discrimination against individuals
with limited English proficiency
(LEP), and also prohibits a. ACA section 6102 requires owners,
operators, discrimination in healthcare and administrators of LTC facilities to
adopt
programs and activities that receive effective compliance.
federal funding, based on race, c. ACA section 6002 requires the
establishment color, national origin, sex, age, or of a transparency program, now
known as CMS disability. Open Payments.
a.ACA section 6102
b.ACA section 1557
c. ACA section 6002
Which statement is TRUE regarding a. Compliance programs are considered more
compliance programs? dangerous if they are developed but not
a.Compliance programs are implemented.
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.
An individual's understanding of the a. annual
evaluations 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
WITH ACCURATE / VERIFIED
ANSWERS
Terms in this set (781)
True or False: True
The ACA requires that all providers
adopt a compliance plan as a ref. ACA section
6102 condition of enrollment with
Medicare, Medicaid, and Children's
Health Insurance Program (CHIP).
According to HHS-OIG - what are 1.Protect our
programs three important reasons for proper 2.Protect
your patients documentation in Compliance? 3.Protect
the Provider (hint: protections)
https://oig.hhs.gov/newsroom/podcasts/2011/hea
t/heat09-
trans.asp#:~:text=Proper%20documentation%2C%
20both%20in%20patients,to%20protect%20you%
20the%20provider.
,At which level of the Medicare Part c. . third level of
appeal A or Part B appeals process is the
appeal decision by the Office of Frist level - redetermination by Medicare
Medicare Hearings and Appeals contractor
(OMHA)? Second level - reconsideration by Independent
a.first level of appeal contractor
b. second level of appeal Third appeal - Administrative Law Judge (ALJ)
c. third level of appeal hearing
d. fourth level of appeal Fourth appeal - review by Medicare Appeals
Council
Fifth appeal - review in Federal District Court
https://www.hhs.gov/about/agencies/omha/the-
appeals-process/index.html
What should CCO be able to do? a. Leadership skills,
(What skills should this person c. Skills to design and implement a
compliance have?) Choose all that apply. program, and
a.Leadership skills. d. Be able to anticipate new risk areas.
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.
Which of the following is an c. non-retaliation for whistleblowers
absolute necessity in order to have
a successful Compliance Program?
a.continuous training
and improvements
b. effective reporting path
c. non-retaliation for whistleblowers
d. reliable and equal discipline
,A Compliance Program with well d. will not be successful without the proper
written policies and procedures: oversight
a.can be successful if consistently
reviewed and maintained Regardless of having the best written policies in
b. cannot be effective due to the place that are reviewed/maintained consistently,
sheer volume presented and read and disseminated accordingly, will fail
if
c. will be effective if read by there is no proper oversight to ensure they
are management actually being followed and understood.
d. will not be successful without the
proper oversight
A Compliance Officer can achieve a b. increasing management involvement.
higher level of compliance and
ethics engagement by: Compliance is everyone's responsibility, but
a.ensuring leadership reads the management involvement is crucial. They have
a policies direct contact with employees, they know
and
b. increasing management understand their staff's needs and concerns,
and involvement have the most influence over employee's
actions
c. responding to compliance and attitudes. Employees most likely use
their hotline calls direct manager(s) to raise concerns and
the
d. monitoring the code of conduct reason they are so critical for an organization to
foster a culture of compliance.
Which of the following requires c. Balance Budget Act of
1997 providers to be permanently
excluded from all federal health Also known as a BBA "three strikes
rule" 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 1128d
, What section of the ACA prevents b. ACA section 1557 is the correct
answer. discrimination against individuals
with limited English proficiency
(LEP), and also prohibits a. ACA section 6102 requires owners,
operators, discrimination in healthcare and administrators of LTC facilities to
adopt
programs and activities that receive effective compliance.
federal funding, based on race, c. ACA section 6002 requires the
establishment color, national origin, sex, age, or of a transparency program, now
known as CMS disability. Open Payments.
a.ACA section 6102
b.ACA section 1557
c. ACA section 6002
Which statement is TRUE regarding a. Compliance programs are considered more
compliance programs? dangerous if they are developed but not
a.Compliance programs are implemented.
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.
An individual's understanding of the a. annual
evaluations 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
