CHC EXAM questions with correct answers

2004- Federal Sentencing Commission released "Ch 8 Part B- Remedying Harm from Criminal Conduct, and Effective Compliance and Ethics Program" - Answer These revisions focused on effective compliance and ethics programs February 27, 1997 - Answer The OIG's open letter to providers- encourages health care organization to implement compliance programs in order to protect themselves from fraud and abuse. Model compliance plan for Clinical Laboratory was offered as guidance. HHS Office of OIG in conjunction w/ Justice Department in responsible for enforcing the rules and regulations under - Answer Enforcing the rules and regulation under Medicare/Medicaid laws outlined as part of the Social Security Act & Administered by CMS False Claim Act (FCA) - Answer Empowers government to investigate and bring civil action in fraud case. Implemented during Civil War to curb war time price gouging Also, allow private citizen to bring civil action against an organization in the name of the US. The action provided significant incentive for the private citizen to come forward. Qui Tam (whistle blower) Sometimes called Lincoln's Laws as implemented during the Civil War to protect against price gouging to the military Balance Budget Act of 1997 - Answer 3 strike rule and you're out of clause. Permanent expulsion for healthcare organization found guilty of fraud for a 3rd time OIG Top 10 reasons to implement a compliance program (6-10) - Answer Quality of care provided to patients is enhanced by effective comp