CHPC PRACTICE TEST QUESTIONS & ANSWERS
Organizations receiving more than $5 million in Medicaid funds must provide education
on the False Claims Act in accordance with the _______. - Answers :Deficit Reduction
Act
Corporate integrity agreements are negotiated primarily between the - Answers :OIG
and the health care entity
A hotline caller states the coding department was instructed to code based on LCD
requirements regardless of medical record information. Which of the following should be
the compliance professional's FIRST action?
a. direct the coding supervisor to follow the applicable policy
b. incorporate the coding issue into next year's risk assessment
c. design a review to find facts and circumstances related to the compliant
d. engage outside counsel to protect the underlying facts from discovery - Answers :C-
Design a review to find facts and circumstances related to the compliant
Which of the following are MOST relevant in evaluating the effectiveness of a
compliance training program?
1. percent of target audience that has attended
2. whether the training is computer-based on classroom-based
3. whether training adequately addresses areas of concern
4. improvement shown in pre- and post-training quizzes - Answers :1, 3, and 4 only
Qui tam actions enable any person to bring forth action to the - Answers :government,
based on original information
An individual's understanding of the compliance aspects of their job can BEST be
enhanced by including compliance in - Answers :annual evaluations
Under HIPAA, a covered entity is required to disclose Protected Health Information
(PHI) when:
a. the disclosure is requested by the police department
b. a subpoena signed by an attorney is received
c. the disclosure is required by medical staff bylaws
d. the Secretary of DHHS requests the information - Answers :The secretary of DHHS
requests the information
The annual OIG workplan is a document that outlines the OIG's annual - Answers
:investigation ideas
Which of the following agencies indicates a self-evaluation after discovery of potentially
fraudulent acts - Answers :OIG
, Reporting systems should be:
a. marketed to contractors
b. outsourced to a vendor
c. operated by management
d. publicized to all employees - Answers :publicized to all employees
An employee reports a potential problem with the attending physician's presence for
surgery. Which of the following is the compliance professional's BEST action? -
Answers :Investigate the issue
A compliance professional conducts an investigation into allegations of physicians and
nurses taking pictures of injuries and posting them on a social network. It is confirmed
that two physicians and a nurse have engaged in this behavior. Which of the following is
the compliance professional's and HR director's BEST action? - Answers :Review and
adhere to the organization's disciplinary policy
Coinsurance and deductibles can be waived
a. for any federal payors
b. during the admission process
c. following payment to the third party
d. if there is proven financial hardship - Answers :if there is proven financial hardship
organizational policies and procedures should be - Answers :reviewed periodically
"It is time to contact the compliance department" is the title of a program to educate
employees. Which of the following is the compliance professional's BEST method to
communicate this program to employees? - Answers :using adult learning techniques
the purpose of attorney-client privilege is to - Answers :encourage full and frank
communication between attorneys and their clients
Which of the following governmental bodies has enforcement authority for HIPAA
privacy? - Answers :OCR
A compliance professional identified an issue with medical necessity. The compliance
professional should collaborate with the:
a. case manager
b. billing clerk
c. documentation specialist
d. patient account representative - Answers :case manager
When non-compliance is substantiated, disciplinary action should be administered
a. within 30 days
b. if intent is proven
c. in a consistent manner
Organizations receiving more than $5 million in Medicaid funds must provide education
on the False Claims Act in accordance with the _______. - Answers :Deficit Reduction
Act
Corporate integrity agreements are negotiated primarily between the - Answers :OIG
and the health care entity
A hotline caller states the coding department was instructed to code based on LCD
requirements regardless of medical record information. Which of the following should be
the compliance professional's FIRST action?
a. direct the coding supervisor to follow the applicable policy
b. incorporate the coding issue into next year's risk assessment
c. design a review to find facts and circumstances related to the compliant
d. engage outside counsel to protect the underlying facts from discovery - Answers :C-
Design a review to find facts and circumstances related to the compliant
Which of the following are MOST relevant in evaluating the effectiveness of a
compliance training program?
1. percent of target audience that has attended
2. whether the training is computer-based on classroom-based
3. whether training adequately addresses areas of concern
4. improvement shown in pre- and post-training quizzes - Answers :1, 3, and 4 only
Qui tam actions enable any person to bring forth action to the - Answers :government,
based on original information
An individual's understanding of the compliance aspects of their job can BEST be
enhanced by including compliance in - Answers :annual evaluations
Under HIPAA, a covered entity is required to disclose Protected Health Information
(PHI) when:
a. the disclosure is requested by the police department
b. a subpoena signed by an attorney is received
c. the disclosure is required by medical staff bylaws
d. the Secretary of DHHS requests the information - Answers :The secretary of DHHS
requests the information
The annual OIG workplan is a document that outlines the OIG's annual - Answers
:investigation ideas
Which of the following agencies indicates a self-evaluation after discovery of potentially
fraudulent acts - Answers :OIG
, Reporting systems should be:
a. marketed to contractors
b. outsourced to a vendor
c. operated by management
d. publicized to all employees - Answers :publicized to all employees
An employee reports a potential problem with the attending physician's presence for
surgery. Which of the following is the compliance professional's BEST action? -
Answers :Investigate the issue
A compliance professional conducts an investigation into allegations of physicians and
nurses taking pictures of injuries and posting them on a social network. It is confirmed
that two physicians and a nurse have engaged in this behavior. Which of the following is
the compliance professional's and HR director's BEST action? - Answers :Review and
adhere to the organization's disciplinary policy
Coinsurance and deductibles can be waived
a. for any federal payors
b. during the admission process
c. following payment to the third party
d. if there is proven financial hardship - Answers :if there is proven financial hardship
organizational policies and procedures should be - Answers :reviewed periodically
"It is time to contact the compliance department" is the title of a program to educate
employees. Which of the following is the compliance professional's BEST method to
communicate this program to employees? - Answers :using adult learning techniques
the purpose of attorney-client privilege is to - Answers :encourage full and frank
communication between attorneys and their clients
Which of the following governmental bodies has enforcement authority for HIPAA
privacy? - Answers :OCR
A compliance professional identified an issue with medical necessity. The compliance
professional should collaborate with the:
a. case manager
b. billing clerk
c. documentation specialist
d. patient account representative - Answers :case manager
When non-compliance is substantiated, disciplinary action should be administered
a. within 30 days
b. if intent is proven
c. in a consistent manner
