CPCO UPDATED ACTUAL EXAM QUESTIONS CORRECT ANSWERS GRADED A PLUS
Question:
Hospital compliance guidance was published by the OIG in February 1998. When was the
supplemental compliance guidance for hospitals published?
Answer:
2005 Response Feedback: Compliance Program Guidance for Hospitals (63 Fed. Reg. 8987;
February 23, 1998) Supplemental Compliance Program Guidance for Hospitals (70 Fed. Reg. 4858;
January 31, 2005)
Question:
Kim is the Compliance Officer for a large provider group. One of the billers for the group enters
codes from the encounter form every evening before she goes home and then finishes in the morning
when she returns. She often enters an encounter twice. She usually catches the mistake when the
insurance checks are sent to the office and returns the overpayment to the insurance carrier. This is
an example of:
Answer:
Abuse Response Feedback: CMS goes on to define abuse as "practices that, either directly or
indirectly, result in unnecessary costs to the Medicare Program." Improper billing practices.
Question:
Justin works at the local hospital in the billing department. He wants to learn more about the agency
that fights Medicare Fraud. Which is the best answer below?
Answer:
Office of Inspector General (OIG) Response Feedback: Since its 1976 establishment, OIG has been
at the forefront of the Nation's efforts to fight waste, fraud and abuse in Medicare, Medicaid and
more than 300 other HHS programs.
Question:
, According to Inspector General Daniel Levinson, what can help reduce enforcement on a provider
from a CIA to a CCA?
Answer:
provider has a robust and effective compliance program Response Feedback: Inspector General
Daniel Levinson disseminated an Open Letter to Healthcare Providers in 2006, in which he
discussed the current enforcement and noted that, "many providers have independently developed
robust and effective compliance programs, which include internal auditing mechanisms. In
appropriate cases, we have agreed to reduce the obligation on providers settling health care fraud
matters by entering into Certification of Compliance Agreements (CCAs), rather than more
extensive CIAs.
Question:
In addition to hospitals, what other type of facility did the OIG provide supplemental compliance
program guidance for?
Answer:
Nursing Facilities Response Feedback: Supplemental compliance program guidance was published
for nursing facilities in September 2008.
Question:
CPUP was the first large fraud case that involved a teaching hospital where Residents and Fellows
worked and was located in:
Answer:
Pennsylvania Response Feedback: Pennsylvania. The clinical practices of the University of
Pennsylvania (CPUP) was the first major audit that targeted teaching hospitals in 1995.
Question:
Department of Labor requires compliance with employee and employer laws including:
Answer:
FLSA, OSHA, CRA, ERISA Response Feedback: The Department of Labor requires compliance
with the employee and employer laws including the Fair Labor Standards Act (FLSA), Occupational
Safety and Health Act (OSHA), Civil Rights Act (CRA), and Employee Retirement and Income
Safety Act (ERISA).
Question:
Hospital compliance guidance was published by the OIG in February 1998. When was the
supplemental compliance guidance for hospitals published?
Answer:
2005 Response Feedback: Compliance Program Guidance for Hospitals (63 Fed. Reg. 8987;
February 23, 1998) Supplemental Compliance Program Guidance for Hospitals (70 Fed. Reg. 4858;
January 31, 2005)
Question:
Kim is the Compliance Officer for a large provider group. One of the billers for the group enters
codes from the encounter form every evening before she goes home and then finishes in the morning
when she returns. She often enters an encounter twice. She usually catches the mistake when the
insurance checks are sent to the office and returns the overpayment to the insurance carrier. This is
an example of:
Answer:
Abuse Response Feedback: CMS goes on to define abuse as "practices that, either directly or
indirectly, result in unnecessary costs to the Medicare Program." Improper billing practices.
Question:
Justin works at the local hospital in the billing department. He wants to learn more about the agency
that fights Medicare Fraud. Which is the best answer below?
Answer:
Office of Inspector General (OIG) Response Feedback: Since its 1976 establishment, OIG has been
at the forefront of the Nation's efforts to fight waste, fraud and abuse in Medicare, Medicaid and
more than 300 other HHS programs.
Question:
, According to Inspector General Daniel Levinson, what can help reduce enforcement on a provider
from a CIA to a CCA?
Answer:
provider has a robust and effective compliance program Response Feedback: Inspector General
Daniel Levinson disseminated an Open Letter to Healthcare Providers in 2006, in which he
discussed the current enforcement and noted that, "many providers have independently developed
robust and effective compliance programs, which include internal auditing mechanisms. In
appropriate cases, we have agreed to reduce the obligation on providers settling health care fraud
matters by entering into Certification of Compliance Agreements (CCAs), rather than more
extensive CIAs.
Question:
In addition to hospitals, what other type of facility did the OIG provide supplemental compliance
program guidance for?
Answer:
Nursing Facilities Response Feedback: Supplemental compliance program guidance was published
for nursing facilities in September 2008.
Question:
CPUP was the first large fraud case that involved a teaching hospital where Residents and Fellows
worked and was located in:
Answer:
Pennsylvania Response Feedback: Pennsylvania. The clinical practices of the University of
Pennsylvania (CPUP) was the first major audit that targeted teaching hospitals in 1995.
Question:
Department of Labor requires compliance with employee and employer laws including:
Answer:
FLSA, OSHA, CRA, ERISA Response Feedback: The Department of Labor requires compliance
with the employee and employer laws including the Fair Labor Standards Act (FLSA), Occupational
Safety and Health Act (OSHA), Civil Rights Act (CRA), and Employee Retirement and Income
Safety Act (ERISA).
