CPMA Chapter 1, Top Questions and
answers, 100% Accurate. Rated A+
Stark Law - ✔✔-Physician Self Referral Law
Prohibits a physician from making a referral to an entity with which they or their immediate family has a
financial relationship if the referral is for the furnishing of designated health services
RAT-STATS - ✔✔-A statistical software that is a valuable analytical tool used by auditors
Components of RAT-STATS that should be used to perform CIA Claims Review - ✔✔-"Random Numbers"
to draw random samples for both the Discovery Sample and the Full Sample
"Variable Appraisaisals" to calculate the mean & standard deviation of the overpayment amount in the
sample
"Sample Size Estimator" to estimate the size of the full sample
CIA Reportable Events - ✔✔-1. A substantial overpayment
2. A potential violation of criminal, civil, or admistrative laws
3. Filing of a bankruptcy petition
OIG Work Plan - ✔✔-Released annually and identifies priority areas for OIG review/investigation which
the agency believes are HHS' most vulnerable programs and activities. The goal is to improve HHS
agency efficiency and effectiveness.
CIA - ✔✔-Coporate Integrity Agreement - an agreement between the OIG and a health care provider or
other entity when serious misconduct (fraudulent or abusive type action) is discovered through an audit
of self-disclosure. It is detailed and restrictive.
Government can do this instead of excluding
Typical term is 5 years
answers, 100% Accurate. Rated A+
Stark Law - ✔✔-Physician Self Referral Law
Prohibits a physician from making a referral to an entity with which they or their immediate family has a
financial relationship if the referral is for the furnishing of designated health services
RAT-STATS - ✔✔-A statistical software that is a valuable analytical tool used by auditors
Components of RAT-STATS that should be used to perform CIA Claims Review - ✔✔-"Random Numbers"
to draw random samples for both the Discovery Sample and the Full Sample
"Variable Appraisaisals" to calculate the mean & standard deviation of the overpayment amount in the
sample
"Sample Size Estimator" to estimate the size of the full sample
CIA Reportable Events - ✔✔-1. A substantial overpayment
2. A potential violation of criminal, civil, or admistrative laws
3. Filing of a bankruptcy petition
OIG Work Plan - ✔✔-Released annually and identifies priority areas for OIG review/investigation which
the agency believes are HHS' most vulnerable programs and activities. The goal is to improve HHS
agency efficiency and effectiveness.
CIA - ✔✔-Coporate Integrity Agreement - an agreement between the OIG and a health care provider or
other entity when serious misconduct (fraudulent or abusive type action) is discovered through an audit
of self-disclosure. It is detailed and restrictive.
Government can do this instead of excluding
Typical term is 5 years
