AHIP GENERAL COMPLIANCE
QUESTIONS AND ANSWERS
c Compliance is the responsibility of the compliance officer, compliance committee and upper
management only - False
Ways to report a compliance issue include - All of the above
What is the policy of non-retaliation - Protects employees who, in good faith, report suspected non-
compliance
These are examples of issues that can be reported to a compliance department :suspected fraud, waste,
and abuse; potential health privacy violation and unethical behavior/employee misconduct - True
Once a corrective action plan begins addressing non compliance or fraud, waste and abuse committed by
a csponsors cemployee cor cfirst ctier, cdownstream, cor crelated centity's c(fdr's) cemployee, congoing
cmonitoring cor cthe ccorrective cactions cis cnot cnecessary c- cFalse
Medicare cparts cc cand cd cplan csponsors care cnot crequired cto chave ca ccompliance cprogram c- cFalse
At ca cminimum, can ceffective ccompliance cprogram cincludes cfour ccore crequirements c- cFalse
Standards cof cconduct care cthe csame cfor cevery cMedicare cparts cc cand cd csponsor c- cFalse
Correcting cnon-compliance c- cProtects cenrollees, cavoids crecurrence cof cthe csame cnon-compliance, cand
cpromotes cefficiency
What care csome cof cthe cconsequences cfor cnon-compliance, cfraudulent, cor cunethical cbehavior c- cAll cof
cthe cabove
QUESTIONS AND ANSWERS
c Compliance is the responsibility of the compliance officer, compliance committee and upper
management only - False
Ways to report a compliance issue include - All of the above
What is the policy of non-retaliation - Protects employees who, in good faith, report suspected non-
compliance
These are examples of issues that can be reported to a compliance department :suspected fraud, waste,
and abuse; potential health privacy violation and unethical behavior/employee misconduct - True
Once a corrective action plan begins addressing non compliance or fraud, waste and abuse committed by
a csponsors cemployee cor cfirst ctier, cdownstream, cor crelated centity's c(fdr's) cemployee, congoing
cmonitoring cor cthe ccorrective cactions cis cnot cnecessary c- cFalse
Medicare cparts cc cand cd cplan csponsors care cnot crequired cto chave ca ccompliance cprogram c- cFalse
At ca cminimum, can ceffective ccompliance cprogram cincludes cfour ccore crequirements c- cFalse
Standards cof cconduct care cthe csame cfor cevery cMedicare cparts cc cand cd csponsor c- cFalse
Correcting cnon-compliance c- cProtects cenrollees, cavoids crecurrence cof cthe csame cnon-compliance, cand
cpromotes cefficiency
What care csome cof cthe cconsequences cfor cnon-compliance, cfraudulent, cor cunethical cbehavior c- cAll cof
cthe cabove
