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Related to Legal Doctrines for Protection from Disclosure to
protect certain
documents during the course of discovery. What is the work
product doctrine?
a. Ensures that attorney documentation is accessible to the
hospital.
b. Ensures that attorney documentation is accessible to the
OIG.
c. Protects attorney documents that were prepared for litigation
purposes.
d. Allows the hospital to protect documents sent to the
attorney. - ANSWER-c. Protects attorney documents that
were prepared for litigation purposes
When should counsel be involved during an internal
investigation?
a. If corporation may have to disclose inappropriate conduct
and take remedial action.
b. If there is an inadvertent billing error.
,c. If there is a question about the training program.
d. If there is fraudulent behavior that the CCO wants to cover
up. - ANSWER-a. If corporation may have to disclose
inappropriate conduct and take remedial action.
Which of the following agencies indicate a self-evaluation
after discovery of
potentially fraudulent
acts?
a. CMS
b. OIG
c. OCR
d. OSHA - ANSWER-b. OIG
Fill in the blank:
The Healthcare Fraud and Abuse Control (HFCA) program
requires the ___ and
___ to coordinate federal, state, and local health care law
enforcement
activities, provide guidance to providers on fraudulent
practices, and establish a
national data bank to receive and report final adverse actions
against providers.
- ANSWER-OIG and
DOJ
,Health Care Financing Administration (HCFA) encouraged one
of the following
to promote consistency in interpretation
of claims?
a.
Education
b.
Reporting
c.
Discipline
d. Statistical sampling - ANSWER-d.
Statistical sampling
Related to Corporate Integrity Agreements with the government,
what is an IRO
and what are the details of how it
works?
Choose 2
answers.
a. Independent
Reorganization
Operation.
b. They do the
auditing required by a
CIA.
c. The OIG
hires them.
, d. They need to be fair and
unbiased and can't have a
financial relationship with
the hospital. - ANSWER-b.
They do the auditing required
by a CIA.
d. They need to be fair and
unbiased and can't have a
financial relationship with
the
hospital.
Explanation:
IROs need to meet criteria and follow the AICPA and SEC
guidance (unbiased judgement, honest neutrality, and
demonstrate independence among other requirements)
The IRO is conducting a Claim Review for a hospital under a
CIA and discovers that there is a discrepancy between the
dollar difference between the amount that was reimbursed and
the amount that should have been reimbursed when
conducting a Discovery Sample.
Which of the following is false:
a. The dollar difference resulted in an overpayment. And when
converted to percentage, the resulting calculation is the error
rate
b. The net financial error rate calculated was under 10%, no
need to conduct a