1|Page
HCCA CHC/CHPC COMPLIANCE EXAM QUESTION BANK |
FREQUENTLY TESTED QUESTIONS WITH CORRECT
ANSWERS | BRAND NEW!
At which level of the Medicare Part A or Part B appeals process is the
appeal decision by the Office of Medicare Hearings and Appeals
(OMHA)?
a. first level of appeal
b. second level of appeal
c. third level of appeal
d. fourth level of appeal ......ANSWER......c. . third level of appeal
Frist level - redetermination by Medicare contractor
Second level - reconsideration by Independent contractor
Third appeal - Administrative Law Judge (ALJ) hearing
Fourth appeal - review by Medicare Appeals Council
Fifth appeal - review in Federal District Court
https://www.hhs.gov/about/agencies/omha/the-appeals-
process/index.html
What should CCO be able to do? (What skills should this person have?)
Choose all that apply.
a. Leadership skills.
,2|Page
b. Oversee the coding department.
c. Skills to design and implement a compliance program.
d. Be able to anticipate new risk areas.
e. Practical experience with documenting medical necessity.
......ANSWER......a. Leadership skills,
c. Skills to design and implement a compliance program, and
d. Be able to anticipate new risk areas.
Which of the following is an absolute necessity in order to have a
successful Compliance Program?
a. continuous training and improvements
b. effective reporting path
c. non-retaliation for whistleblowers
d. reliable and equal discipline ......ANSWER......c. non-retaliation for
whistleblowers
A Compliance Program with well written policies and procedures:
a. can be successful if consistently reviewed and maintained
b. cannot be effective due to the sheer volume presented
c. will be effective if read by management
d. will not be successful without the proper oversight ......ANSWER......d.
will not be successful without the proper oversight
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Regardless of having the best written policies in place that are
reviewed/maintained consistently, and read and disseminated
accordingly, will fail if there is no proper oversight to ensure they are
actually being followed and understood.
A Compliance Officer can achieve a higher level of compliance and
ethics engagement by:
a. ensuring leadership reads the policies
b. increasing management involvement
c. responding to compliance hotline calls
d. monitoring the code of conduct ......ANSWER......b. increasing
management involvement.
Compliance is everyone's responsibility, but management involvement
is crucial. They have a direct contact with employees, they know and
understand their staff's needs and concerns, and have the most
influence over employee's actions and attitudes. Employees most likely
use their direct manager(s) to raise concerns and the reason they are so
critical for an organization to foster a culture of compliance.
Which of the following requires providers to be permanently excluded
from all federal health care programs if found guilty of a healthcare
related fraud a third time:
a. Deficit Reduction Act of 2005
b. False Claims Act
, 4|Page
c. Balance Budget Act of 1997
d. Social Security Act section 1128d ......ANSWER......c. Balance Budget
Act of 1997
Also known as a BBA "three strikes rule"
What section of the ACA prevents discrimination against individuals
with limited English proficiency (LEP), and also prohibits discrimination
in healthcare programs and activities that receive federal funding,
based on race, color, national origin, sex, age, or disability.
a. ACA section 6102
b. ACA section 1557
c. ACA section 6002 ......ANSWER......b. ACA section 1557 is the correct
answer.
a. ACA section 6102 requires owners, operators, and administrators of
LTC facilities to adopt effective compliance.
c. ACA section 6002 requires the establishment of a transparency
program, now known as CMS Open Payments.
Which statement is TRUE regarding compliance programs?
a. Compliance programs are considered more dangerous if they are
developed but not implemented.
HCCA CHC/CHPC COMPLIANCE EXAM QUESTION BANK |
FREQUENTLY TESTED QUESTIONS WITH CORRECT
ANSWERS | BRAND NEW!
At which level of the Medicare Part A or Part B appeals process is the
appeal decision by the Office of Medicare Hearings and Appeals
(OMHA)?
a. first level of appeal
b. second level of appeal
c. third level of appeal
d. fourth level of appeal ......ANSWER......c. . third level of appeal
Frist level - redetermination by Medicare contractor
Second level - reconsideration by Independent contractor
Third appeal - Administrative Law Judge (ALJ) hearing
Fourth appeal - review by Medicare Appeals Council
Fifth appeal - review in Federal District Court
https://www.hhs.gov/about/agencies/omha/the-appeals-
process/index.html
What should CCO be able to do? (What skills should this person have?)
Choose all that apply.
a. Leadership skills.
,2|Page
b. Oversee the coding department.
c. Skills to design and implement a compliance program.
d. Be able to anticipate new risk areas.
e. Practical experience with documenting medical necessity.
......ANSWER......a. Leadership skills,
c. Skills to design and implement a compliance program, and
d. Be able to anticipate new risk areas.
Which of the following is an absolute necessity in order to have a
successful Compliance Program?
a. continuous training and improvements
b. effective reporting path
c. non-retaliation for whistleblowers
d. reliable and equal discipline ......ANSWER......c. non-retaliation for
whistleblowers
A Compliance Program with well written policies and procedures:
a. can be successful if consistently reviewed and maintained
b. cannot be effective due to the sheer volume presented
c. will be effective if read by management
d. will not be successful without the proper oversight ......ANSWER......d.
will not be successful without the proper oversight
,3|Page
Regardless of having the best written policies in place that are
reviewed/maintained consistently, and read and disseminated
accordingly, will fail if there is no proper oversight to ensure they are
actually being followed and understood.
A Compliance Officer can achieve a higher level of compliance and
ethics engagement by:
a. ensuring leadership reads the policies
b. increasing management involvement
c. responding to compliance hotline calls
d. monitoring the code of conduct ......ANSWER......b. increasing
management involvement.
Compliance is everyone's responsibility, but management involvement
is crucial. They have a direct contact with employees, they know and
understand their staff's needs and concerns, and have the most
influence over employee's actions and attitudes. Employees most likely
use their direct manager(s) to raise concerns and the reason they are so
critical for an organization to foster a culture of compliance.
Which of the following requires providers to be permanently excluded
from all federal health care programs if found guilty of a healthcare
related fraud a third time:
a. Deficit Reduction Act of 2005
b. False Claims Act
, 4|Page
c. Balance Budget Act of 1997
d. Social Security Act section 1128d ......ANSWER......c. Balance Budget
Act of 1997
Also known as a BBA "three strikes rule"
What section of the ACA prevents discrimination against individuals
with limited English proficiency (LEP), and also prohibits discrimination
in healthcare programs and activities that receive federal funding,
based on race, color, national origin, sex, age, or disability.
a. ACA section 6102
b. ACA section 1557
c. ACA section 6002 ......ANSWER......b. ACA section 1557 is the correct
answer.
a. ACA section 6102 requires owners, operators, and administrators of
LTC facilities to adopt effective compliance.
c. ACA section 6002 requires the establishment of a transparency
program, now known as CMS Open Payments.
Which statement is TRUE regarding compliance programs?
a. Compliance programs are considered more dangerous if they are
developed but not implemented.
