Compliance 101 Exam/ 107 Q&A/ A+ Score
Solution
A whistleblower can receive a % of the govt's total award - Answer: 15-25% if DOJ
assumes the case or 25-30% if DOJ declines
To avoid lengthy and expensive litigation, an organization can negotiate a
____________with the govt admits no fault or liability but does submit to a govt
plan for corrective action. - Answer: CIA
Length of CIAs - Answer: 3-5 yrs with some lasting up to 8 yrs
1984 Congress enacted Sentencing reform act which includes FSG - Answer: act
designed to correct inequities in federal sentencing and give guidance for
assessing fines and methods for calculation of culpability score.
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,The culpability score - Answer: calculation of the degree of blame or guilt used to
determine fines, restitution, forfeiture, and probation.
If an upper level employee has participated in or was willfully ignorant of an
offense, - Answer: the likelihood of culpability score will be increased.
If an organization reports a violation promptly, - Answer: the culpability score may
be mitigated.
An aggravating factor in FSG - Answer: is that the organization has had a repeated
offense
A mitigating factor for FSG - Answer: is that the organization cooperated with the
govt investigators
2010 FSG amendment changes includes way to further reduce culpability scores: -
Answer: C&E program has responsibility- to report directly to board or
appropriate subgroup, to detected offense before external discovery, prompt
reporting, no one with OP responsibility participated in, condoned, or was willfully
ignorant of the offense.
Which of the following is an aggravating factor to a culpability score in the Federal
Sentencing Commission released "Chapter 8 Part B - Remedying Harm from
Criminal Conduct, and Effective Compliance and Ethics Program?" - Answer: If the
violation was a repeat offense;
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, The OIG believes every effective compliance Program begins with a formal
commitment to seven basic elements, based on and expanding upon the seven
steps of the Federal Sentencing Guidelines. Which of the following is not one of
the seven elements in the guidance for hospitals? - Answer: Terminating
employees who have been investigated and found to have committed prior
fraudulent acts
According to the text, which of the following are "overlooked groups" when it
comes to Standards of Conduct/Policies and Procedures? (Choose all that apply) -
Answer: Suppliers
Vendors
Independent Contractors
According to the text, the "lion's share of fraud and abuse offenses is attributed
to": - Answer: Documentation and billing irregularities
: The practice of using a billing code that provides a higher reimbursement rate
than the billing code that actually reflects the service furnished is known as: -
Answer: Upcoding
The main focus of the Compliance Officer should be all of the following, except: -
Answer: Administering discipline for those individuals that do not adhere to
policies and procedures;
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Solution
A whistleblower can receive a % of the govt's total award - Answer: 15-25% if DOJ
assumes the case or 25-30% if DOJ declines
To avoid lengthy and expensive litigation, an organization can negotiate a
____________with the govt admits no fault or liability but does submit to a govt
plan for corrective action. - Answer: CIA
Length of CIAs - Answer: 3-5 yrs with some lasting up to 8 yrs
1984 Congress enacted Sentencing reform act which includes FSG - Answer: act
designed to correct inequities in federal sentencing and give guidance for
assessing fines and methods for calculation of culpability score.
Page 1 of 19
,The culpability score - Answer: calculation of the degree of blame or guilt used to
determine fines, restitution, forfeiture, and probation.
If an upper level employee has participated in or was willfully ignorant of an
offense, - Answer: the likelihood of culpability score will be increased.
If an organization reports a violation promptly, - Answer: the culpability score may
be mitigated.
An aggravating factor in FSG - Answer: is that the organization has had a repeated
offense
A mitigating factor for FSG - Answer: is that the organization cooperated with the
govt investigators
2010 FSG amendment changes includes way to further reduce culpability scores: -
Answer: C&E program has responsibility- to report directly to board or
appropriate subgroup, to detected offense before external discovery, prompt
reporting, no one with OP responsibility participated in, condoned, or was willfully
ignorant of the offense.
Which of the following is an aggravating factor to a culpability score in the Federal
Sentencing Commission released "Chapter 8 Part B - Remedying Harm from
Criminal Conduct, and Effective Compliance and Ethics Program?" - Answer: If the
violation was a repeat offense;
Page 2 of 19
, The OIG believes every effective compliance Program begins with a formal
commitment to seven basic elements, based on and expanding upon the seven
steps of the Federal Sentencing Guidelines. Which of the following is not one of
the seven elements in the guidance for hospitals? - Answer: Terminating
employees who have been investigated and found to have committed prior
fraudulent acts
According to the text, which of the following are "overlooked groups" when it
comes to Standards of Conduct/Policies and Procedures? (Choose all that apply) -
Answer: Suppliers
Vendors
Independent Contractors
According to the text, the "lion's share of fraud and abuse offenses is attributed
to": - Answer: Documentation and billing irregularities
: The practice of using a billing code that provides a higher reimbursement rate
than the billing code that actually reflects the service furnished is known as: -
Answer: Upcoding
The main focus of the Compliance Officer should be all of the following, except: -
Answer: Administering discipline for those individuals that do not adhere to
policies and procedures;
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