CPMA Top Exam Questions and
answers. Approved Rated A+
Which option is NOT part of the seven elements that should be included in a compliance plan based on
the OIG's recommendations?
a. Responding promptly to detected offenses and developing corrective action.
b. Conducting effective training and education.
c. Identifying employees on the exclusions list.
d. Developing effective lines of communication. - ✔✔-c. Identifying employees on the exclusions list.
The OIG's Compliance Program Guidance for Individual and Small Physician Group Practices identifies
four risk areas affecting physician practices. What are the four risk areas? - ✔✔-Coding and billing;
reasonable and necessary services; documentation; and improper inducements, kickbacks, and self-
referrals.
What does the MUE table tell? - ✔✔-maximum number of units a procedure can be reported on the
same date of service
What does MUE stand for? - ✔✔-Medically Unlikely Edits
What does CMS stand for? - ✔✔-Centers for Medicare and Medicaid
What does CIA stand for? - ✔✔-Corporate Integrity Agreeement
What is a corporate integrity agreement? - ✔✔-Document outlining the obligations that a company
involved in health care in the United States makes with a federal government agency or a state
government as part of a civil settlement
Which is not a core requirement of CIAs?
a. Restrict employment of ineligible persons.
, b. Hire an OIG employee to oversee the compliance efforts.
c. Develop written standards and policies.
d. Provide an implementation report and annual reports to OIG on the status of the entity's compliance
activities. - ✔✔-b. Hire an OIG employee to oversee the compliance efforts.
What is a Complex audit review? - ✔✔-A complex review is based on data and potential human review
of a medical record or other documentation.
What is an automated audit review? - ✔✔-Review based solely on the submitted claims and regulatory
guidelines. No medical records are needed.
What is Qui Tam Relator? - ✔✔-A person who brings a civil action for a violation for him/herself and for
the US Government
What are the MIPS performance categories? - ✔✔-I. Costs
II. Advance Care Info. (Promoting Interoperability)
III. Quality
IV. Improvement Activities
When a Discovery Sample is performed, what error rate requires a Full Sample to be reviewed? - ✔✔-An
error rate that exceeds five percent.
What program is provided by the OIG to assist in random selection of charts for a Discovery Sample? -
✔✔-The OIG provides a statistical sampling program called RAT-STATS.
When a provider is excluded under the Exclusions Statute, what must he or she do at the end of the
exclusionary period? - ✔✔-The provider must apply for reinstatement.
Which are the requirements for financial penalties to be mitigated in a federal False Claims Act case? -
✔✔--Person self discloses within 30 days of knowing about the violation.
-No criminal prosecution, civil action, or administrative action has commenced
answers. Approved Rated A+
Which option is NOT part of the seven elements that should be included in a compliance plan based on
the OIG's recommendations?
a. Responding promptly to detected offenses and developing corrective action.
b. Conducting effective training and education.
c. Identifying employees on the exclusions list.
d. Developing effective lines of communication. - ✔✔-c. Identifying employees on the exclusions list.
The OIG's Compliance Program Guidance for Individual and Small Physician Group Practices identifies
four risk areas affecting physician practices. What are the four risk areas? - ✔✔-Coding and billing;
reasonable and necessary services; documentation; and improper inducements, kickbacks, and self-
referrals.
What does the MUE table tell? - ✔✔-maximum number of units a procedure can be reported on the
same date of service
What does MUE stand for? - ✔✔-Medically Unlikely Edits
What does CMS stand for? - ✔✔-Centers for Medicare and Medicaid
What does CIA stand for? - ✔✔-Corporate Integrity Agreeement
What is a corporate integrity agreement? - ✔✔-Document outlining the obligations that a company
involved in health care in the United States makes with a federal government agency or a state
government as part of a civil settlement
Which is not a core requirement of CIAs?
a. Restrict employment of ineligible persons.
, b. Hire an OIG employee to oversee the compliance efforts.
c. Develop written standards and policies.
d. Provide an implementation report and annual reports to OIG on the status of the entity's compliance
activities. - ✔✔-b. Hire an OIG employee to oversee the compliance efforts.
What is a Complex audit review? - ✔✔-A complex review is based on data and potential human review
of a medical record or other documentation.
What is an automated audit review? - ✔✔-Review based solely on the submitted claims and regulatory
guidelines. No medical records are needed.
What is Qui Tam Relator? - ✔✔-A person who brings a civil action for a violation for him/herself and for
the US Government
What are the MIPS performance categories? - ✔✔-I. Costs
II. Advance Care Info. (Promoting Interoperability)
III. Quality
IV. Improvement Activities
When a Discovery Sample is performed, what error rate requires a Full Sample to be reviewed? - ✔✔-An
error rate that exceeds five percent.
What program is provided by the OIG to assist in random selection of charts for a Discovery Sample? -
✔✔-The OIG provides a statistical sampling program called RAT-STATS.
When a provider is excluded under the Exclusions Statute, what must he or she do at the end of the
exclusionary period? - ✔✔-The provider must apply for reinstatement.
Which are the requirements for financial penalties to be mitigated in a federal False Claims Act case? -
✔✔--Person self discloses within 30 days of knowing about the violation.
-No criminal prosecution, civil action, or administrative action has commenced
