CPCO
How long do providers have to return monies once identified overpayment? - correct
answer-60 days
Most expenses when developing a complain program are the cost of doing business ; which
is not . - correct answer-When expenses are result of imposition of penalty
A benefit of having a compliance program - correct answer-It shows the practice is making
good faith effort to be compliant
Most important aspect of compliance eprogram - correct answer-Implementation
What does oig acknowledge patient care as?. - correct answer-The first priority of a
physician practice
Federal Sentencing Guidelines - correct answer-Seven basic components of an effective
compliance program
Oig workplan - correct answer-Identify risks they are and will be focusing on
Monitoring - correct answer-Reviewing in a regular basis to confirm compliance. Like once a
month
Double Billing - correct answer-Charging for a membership fee to see physician in addition
to billing insurance for the service
audit - correct answer-Process to determine if a compliance program is effective
When a violation occurs what type of plan should be done - correct answer-Corrective action
When did GAO identify ,educate claims to be at high risk of fraud and abuse - correct
answer-1992
What is CPUP - correct answer-Clinical practices of the university of PA. Resulted in a
settlement of 30$ billion (without admitting wrongdoing) with dept of justice in 1995.
Identified teaching physicians had inappropriately billed Medicare Because medical records
did not sufficiently document their involvement in the services provided by the residents
PATH - correct answer-Physician at teaching hospital audit
Operation bad bundle - correct answer-Involved labs,DME, hospice and home health
OIG created first compliance document for hospitals what year. - correct answer-1998
, Patient Protection and Affordable Care Act (PPACA) - correct answer-In 2010 Mandate a
broad range of providers , suppliers and physicians to adopt a compliance and ethics
program
OIG oversight is Stendhal to programs under what three entities - correct answer-HHS;
CDC; US food and drug admin
Six OIG depts - correct answer-Immediate OIG
Office of audit services
Office of evaluation and inspection
office of management and policy
Office of investigation
Office of counsel
What is the seven basic components of an effective compliance program described by OIG ?
- correct answer-Federal sentencing guidelines
OIG releases what throughout the year that identify risks they are focusing on? - correct
answer-The OIG work plan
Difference between monitoring and auditing - correct answer-Monitoring is more consistent
on a regular basis to confirm compliance (once a month ) where audit is a more formal
review with particular set of standards to look at overall effectiveness ( many yearly )
How many current states require nursing homes to perform background checks? - correct
answer-43
What law does not require that nursing facilities conduct state or federal FBI of investigation
criminal background checks. - correct answer-Federal law
SNFs are under which Medicare parts? - correct answer-A &B
What should be reflected in a billing company's written policies and procedures.? - correct
answer-Current federal and state statutes
How many states require nursing homes to perform FBI checks - correct answer-10
What is the max days after determining there is evidence if fraud should a billing CO take to
notify federal and state authorities - correct answer-60
Same day rule - correct answer-A regulation identified in the OPPS final rule requires all
hospitals to include all OPPS services provided at the same hospital to the same patient on
the same day on the same claim unless certain conditions are met ?
The document guidance for healthcare governing boards on compliance oversight was
collaborated on with who? And what year - correct answer-OIG. AHLA HCCA. HHS. AHIA
2015
How long do providers have to return monies once identified overpayment? - correct
answer-60 days
Most expenses when developing a complain program are the cost of doing business ; which
is not . - correct answer-When expenses are result of imposition of penalty
A benefit of having a compliance program - correct answer-It shows the practice is making
good faith effort to be compliant
Most important aspect of compliance eprogram - correct answer-Implementation
What does oig acknowledge patient care as?. - correct answer-The first priority of a
physician practice
Federal Sentencing Guidelines - correct answer-Seven basic components of an effective
compliance program
Oig workplan - correct answer-Identify risks they are and will be focusing on
Monitoring - correct answer-Reviewing in a regular basis to confirm compliance. Like once a
month
Double Billing - correct answer-Charging for a membership fee to see physician in addition
to billing insurance for the service
audit - correct answer-Process to determine if a compliance program is effective
When a violation occurs what type of plan should be done - correct answer-Corrective action
When did GAO identify ,educate claims to be at high risk of fraud and abuse - correct
answer-1992
What is CPUP - correct answer-Clinical practices of the university of PA. Resulted in a
settlement of 30$ billion (without admitting wrongdoing) with dept of justice in 1995.
Identified teaching physicians had inappropriately billed Medicare Because medical records
did not sufficiently document their involvement in the services provided by the residents
PATH - correct answer-Physician at teaching hospital audit
Operation bad bundle - correct answer-Involved labs,DME, hospice and home health
OIG created first compliance document for hospitals what year. - correct answer-1998
, Patient Protection and Affordable Care Act (PPACA) - correct answer-In 2010 Mandate a
broad range of providers , suppliers and physicians to adopt a compliance and ethics
program
OIG oversight is Stendhal to programs under what three entities - correct answer-HHS;
CDC; US food and drug admin
Six OIG depts - correct answer-Immediate OIG
Office of audit services
Office of evaluation and inspection
office of management and policy
Office of investigation
Office of counsel
What is the seven basic components of an effective compliance program described by OIG ?
- correct answer-Federal sentencing guidelines
OIG releases what throughout the year that identify risks they are focusing on? - correct
answer-The OIG work plan
Difference between monitoring and auditing - correct answer-Monitoring is more consistent
on a regular basis to confirm compliance (once a month ) where audit is a more formal
review with particular set of standards to look at overall effectiveness ( many yearly )
How many current states require nursing homes to perform background checks? - correct
answer-43
What law does not require that nursing facilities conduct state or federal FBI of investigation
criminal background checks. - correct answer-Federal law
SNFs are under which Medicare parts? - correct answer-A &B
What should be reflected in a billing company's written policies and procedures.? - correct
answer-Current federal and state statutes
How many states require nursing homes to perform FBI checks - correct answer-10
What is the max days after determining there is evidence if fraud should a billing CO take to
notify federal and state authorities - correct answer-60
Same day rule - correct answer-A regulation identified in the OPPS final rule requires all
hospitals to include all OPPS services provided at the same hospital to the same patient on
the same day on the same claim unless certain conditions are met ?
The document guidance for healthcare governing boards on compliance oversight was
collaborated on with who? And what year - correct answer-OIG. AHLA HCCA. HHS. AHIA
2015
