CPCO EXAM Questions and Answers
Verified Solutions Latest Update
Question:
Hospital compliance guidance was published by the OIG in February
Question:
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).
Verified Solutions Latest Update
Question:
Hospital compliance guidance was published by the OIG in February
Question:
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).
