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Study Material 2026
Question:
Under Public Law 104-191, the Health Insurance Portability and Accountability Act of 1996 (HIPAA),
what is the name of the national program designed to coordinate Federal, State and local law enforcement
activities with respect to health care fraud and abuse?
Answer:
Health Care Fraud and Abuse Control Program (HCFAC)
Question:
Question 2 According to the Federal Sentencing Guidelines, "To have an effective compliance and ethics
program..., an organization shall exercise due diligence to prevent and detect criminal conduct." The
FSGs also state organizations shall
Answer:
Promote an organizational culture that encourages ethical conduct and a commitment to compliance with
the law.
Question:
Question 3 If a physician practice uses another entity's standards of conduct, the practice must
Answer:
Tailor those materials to the physician practice where they will be applied.
Question:
Question 4 As the compliance contact for your physician practice, you are charged with developing the
policies and procedures related to coding and billing. When developing these policies and procedures,
which of the following statements should be included?
Answer:
For any services billed, documentation must be present in the patient's medical record to support the
services.
, Question:
Question 5 City Orthopedics, a large physician group practice employs several physician assistants and
nurse practitioners. There have been several questions by the physicians on how incident to services
should be billed. The compliance officer has called the Medicare Administrative Contractor for the
practice and was given some information on how incident to services should be billed. Because the
practice will be relying on the information received from the Medicare Administrative Contractor, what
steps should the compliance officer take at the conclusion of the call according to the OIG Compliance
Guidance for Individual and Small Group Physician Practices?
Answer:
Document the conversation and retain the records.
Question:
Question 6 Developing effective compliance policies and procedures is an important part of any
compliance program. To help your practice mitigate compliance risk, policies and procedures should
Answer:
Be sure any time frames or requirements listed can be accomplished given the practice's resources.
Question:
Question 7 Select the best phrase from the list below to complete the following policy statement:
Centennial Medical Associates is committed to following Federal, State, and Local laws, rules,
guidelines, and regulations. To promote this effort, Centennial Medical Associates will perform claims
audits at least on an annual basis to .
Answer:
Verify accuracy of coding and reimbursement for the services performed.
Question:
Question 8 You have just been identified as the compliance officer at your practice. The OIG
Compliance Guidance for Individual and Small Group Physician Practices suggests six specific duties
that may be assigned to you. What is one of those duties?
Answer:
Reviewing reports to see that new employees and vendors have been checked against the OIG's list of
excluded individuals and entities.
Question:
Question 9 For larger physician practices, how frequently does the OIG recommend reporting
compliance activities to the Board of Directors and CEO?
Answer:
Regularly
Study Material 2026
Question:
Under Public Law 104-191, the Health Insurance Portability and Accountability Act of 1996 (HIPAA),
what is the name of the national program designed to coordinate Federal, State and local law enforcement
activities with respect to health care fraud and abuse?
Answer:
Health Care Fraud and Abuse Control Program (HCFAC)
Question:
Question 2 According to the Federal Sentencing Guidelines, "To have an effective compliance and ethics
program..., an organization shall exercise due diligence to prevent and detect criminal conduct." The
FSGs also state organizations shall
Answer:
Promote an organizational culture that encourages ethical conduct and a commitment to compliance with
the law.
Question:
Question 3 If a physician practice uses another entity's standards of conduct, the practice must
Answer:
Tailor those materials to the physician practice where they will be applied.
Question:
Question 4 As the compliance contact for your physician practice, you are charged with developing the
policies and procedures related to coding and billing. When developing these policies and procedures,
which of the following statements should be included?
Answer:
For any services billed, documentation must be present in the patient's medical record to support the
services.
, Question:
Question 5 City Orthopedics, a large physician group practice employs several physician assistants and
nurse practitioners. There have been several questions by the physicians on how incident to services
should be billed. The compliance officer has called the Medicare Administrative Contractor for the
practice and was given some information on how incident to services should be billed. Because the
practice will be relying on the information received from the Medicare Administrative Contractor, what
steps should the compliance officer take at the conclusion of the call according to the OIG Compliance
Guidance for Individual and Small Group Physician Practices?
Answer:
Document the conversation and retain the records.
Question:
Question 6 Developing effective compliance policies and procedures is an important part of any
compliance program. To help your practice mitigate compliance risk, policies and procedures should
Answer:
Be sure any time frames or requirements listed can be accomplished given the practice's resources.
Question:
Question 7 Select the best phrase from the list below to complete the following policy statement:
Centennial Medical Associates is committed to following Federal, State, and Local laws, rules,
guidelines, and regulations. To promote this effort, Centennial Medical Associates will perform claims
audits at least on an annual basis to .
Answer:
Verify accuracy of coding and reimbursement for the services performed.
Question:
Question 8 You have just been identified as the compliance officer at your practice. The OIG
Compliance Guidance for Individual and Small Group Physician Practices suggests six specific duties
that may be assigned to you. What is one of those duties?
Answer:
Reviewing reports to see that new employees and vendors have been checked against the OIG's list of
excluded individuals and entities.
Question:
Question 9 For larger physician practices, how frequently does the OIG recommend reporting
compliance activities to the Board of Directors and CEO?
Answer:
Regularly
