CPCO prep
An effective compliance program can _________________________.
Keep a provider from facing criminal penalties
Make sure a practice or medical organization is 100 percent compliant with federal
regulations
Help create financial success, customer loyalty, community support, and employee
satisfaction
Require starting fresh with new policies and procedures and expensive changes - correct
answer-Help create financial success, customer loyalty, community support, and employee
satisfaction
There is no guarantee that a compliance program will keep a provider from facing criminal
penalties. However, it will help create a culture of compliance, which will lead to customer
loyalty and increased employee satisfaction.
How many elements are required to have a successful compliance program?
Five
Seven
Eight
Nine - correct answer-Seven
The OIG guidance documents utilize the seven elements of the Federal Sentencing
Guidelines as the basis of an effective compliance program.
What term would be used for a practice that, either directly or indirectly, results in
unnecessary costs to the Medicare program?
Fraud
,Mistake
Waste
Abuse - correct answer-Abuse
"Abuse describes practices that, either directly or indirectly, result in unnecessary costs to
the Medicare Program."
Which federal government departments is the OIG not responsible for overseeing?
Centers for Medicare & Medicaid Services (CMS)
Centers for Disease Control and Prevention (CDC)
U.S. Food & Drug Administration (FDA)
Drug Enforcement Agency (DEA) - correct answer-Drug Enforcement Agency (DEA)
The OIG is responsible for overseeing the Centers for Medicare & Medicaid Services (CMS),
and programs under other HHS agencies, including the Centers for Disease Control and
Prevention (CDC), National Institutes of Health (NIH), and the U.S. Food and Drug
Administration (FDA). DEA is overseen by DOJ.
In order for a compliance program to be effective, it will need to be _________.
Reviewed daily for any compliance updates
Regularly reviewed and updated
Reviewed by healthcare lawyers
Reviewed weekly for any compliance updates - correct answer-Regularly reviewed and
updated
Simply implementing a compliance program is not enough. It will need to be reviewed and
updated on a regular basis.
,Which government department is comprised thousands of employees who enforce the
nation's federal criminal laws and help to develop and implement criminal law policies?
Office of Inspector General (OIG)
Centers for Medicare & Medicaid Services (CMS)
Health Care Lawyers Association (HCLA)
Department of Justice (DoJ) - correct answer-Department of Justice (DoJ)
More than 114,000 employees, including hundreds of lawyers, ensure that the Department of
Justice (DOJ) carries out the individual missions of its components.
Sue works for ABC Family Physicians. The providers at this office ask her research the
department that helps to protect patients from unfair treatment or discrimination? What
department is she referring to?
Employment Equality Agency (EEA)
Office for Civil Rights (OCR)
Department of Justice (DoJ)
Office of Inspector General (OIG)
Response Feedback: - correct answer-Office for Civil Rights (OCR)
Civil rights help to protect individuals from unfair treatment or discrimination, because of
race, color, national origin, disability, age, sex (gender), or religion.
In what year did the OIG post guidance for hospitals?
1996
1997
1998
, 1999 - correct answer-The first set of OIG guidance for hospitals was created in 1998.
Which entity below could not bill for medically unnecessary services?
Hospitals
Physicians
Ancillary providers
Patients - correct answer-Patients
There is tremendous pressure to contain healthcare costs, and government payers
necessarily must be on guard against hospitals, physicians, and ancillary providers billing for
wasteful or medically unnecessary services.
Which department is the largest inspector general's office in the federal government?
Office of Inspector General (OIG)
U.S. Department of Health & Human Services (HHS)
Department of Justice (DoJ)
Centers for Medicare & Medicaid Services (CMS) - correct answer-Office of Inspector
General (OIG)
The OIG is the largest inspector general's office in the federal government, with more than
1,700 workers dedicated to combating fraud, waste, and abuse.
Department of Labor requires compliance with employee and employer laws including:
a. FLSA, OSHA, CRA, ERISA
b. OSHA, ADA, HIPAA, ERISA
c. ADA, OCR, HHS, HIPAA
An effective compliance program can _________________________.
Keep a provider from facing criminal penalties
Make sure a practice or medical organization is 100 percent compliant with federal
regulations
Help create financial success, customer loyalty, community support, and employee
satisfaction
Require starting fresh with new policies and procedures and expensive changes - correct
answer-Help create financial success, customer loyalty, community support, and employee
satisfaction
There is no guarantee that a compliance program will keep a provider from facing criminal
penalties. However, it will help create a culture of compliance, which will lead to customer
loyalty and increased employee satisfaction.
How many elements are required to have a successful compliance program?
Five
Seven
Eight
Nine - correct answer-Seven
The OIG guidance documents utilize the seven elements of the Federal Sentencing
Guidelines as the basis of an effective compliance program.
What term would be used for a practice that, either directly or indirectly, results in
unnecessary costs to the Medicare program?
Fraud
,Mistake
Waste
Abuse - correct answer-Abuse
"Abuse describes practices that, either directly or indirectly, result in unnecessary costs to
the Medicare Program."
Which federal government departments is the OIG not responsible for overseeing?
Centers for Medicare & Medicaid Services (CMS)
Centers for Disease Control and Prevention (CDC)
U.S. Food & Drug Administration (FDA)
Drug Enforcement Agency (DEA) - correct answer-Drug Enforcement Agency (DEA)
The OIG is responsible for overseeing the Centers for Medicare & Medicaid Services (CMS),
and programs under other HHS agencies, including the Centers for Disease Control and
Prevention (CDC), National Institutes of Health (NIH), and the U.S. Food and Drug
Administration (FDA). DEA is overseen by DOJ.
In order for a compliance program to be effective, it will need to be _________.
Reviewed daily for any compliance updates
Regularly reviewed and updated
Reviewed by healthcare lawyers
Reviewed weekly for any compliance updates - correct answer-Regularly reviewed and
updated
Simply implementing a compliance program is not enough. It will need to be reviewed and
updated on a regular basis.
,Which government department is comprised thousands of employees who enforce the
nation's federal criminal laws and help to develop and implement criminal law policies?
Office of Inspector General (OIG)
Centers for Medicare & Medicaid Services (CMS)
Health Care Lawyers Association (HCLA)
Department of Justice (DoJ) - correct answer-Department of Justice (DoJ)
More than 114,000 employees, including hundreds of lawyers, ensure that the Department of
Justice (DOJ) carries out the individual missions of its components.
Sue works for ABC Family Physicians. The providers at this office ask her research the
department that helps to protect patients from unfair treatment or discrimination? What
department is she referring to?
Employment Equality Agency (EEA)
Office for Civil Rights (OCR)
Department of Justice (DoJ)
Office of Inspector General (OIG)
Response Feedback: - correct answer-Office for Civil Rights (OCR)
Civil rights help to protect individuals from unfair treatment or discrimination, because of
race, color, national origin, disability, age, sex (gender), or religion.
In what year did the OIG post guidance for hospitals?
1996
1997
1998
, 1999 - correct answer-The first set of OIG guidance for hospitals was created in 1998.
Which entity below could not bill for medically unnecessary services?
Hospitals
Physicians
Ancillary providers
Patients - correct answer-Patients
There is tremendous pressure to contain healthcare costs, and government payers
necessarily must be on guard against hospitals, physicians, and ancillary providers billing for
wasteful or medically unnecessary services.
Which department is the largest inspector general's office in the federal government?
Office of Inspector General (OIG)
U.S. Department of Health & Human Services (HHS)
Department of Justice (DoJ)
Centers for Medicare & Medicaid Services (CMS) - correct answer-Office of Inspector
General (OIG)
The OIG is the largest inspector general's office in the federal government, with more than
1,700 workers dedicated to combating fraud, waste, and abuse.
Department of Labor requires compliance with employee and employer laws including:
a. FLSA, OSHA, CRA, ERISA
b. OSHA, ADA, HIPAA, ERISA
c. ADA, OCR, HHS, HIPAA
