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CMOM-Practice Management Institute| with Questions & Correct Verified Answers

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CMOM-Practice Management Institute| with Questions & Correct Verified Answers

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Uploaded on
September 3, 2024
Number of pages
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Written in
2024/2025
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CMOM-Practice Management
Institute| with Questions & Correct
Verified Answers

Whistleblower - ✔or the "qui tam" provision as it is formally called allows a person that
has knowledge of a false claim against the government to bring an action against the
suspected wrongdoer on behalf of the U.S. government.



Relator - ✔a person that files a qui tam suit on behalf of the government and may share a
percentage of the recovery realized from a successful action ex. patient, disgruntled former
employee or other business contact.



OIG Compliance Plan - ✔There are seven steps



Primary goal of OSHA - ✔To reduce injuries, illnesses and death, and to provide leadership
and encouragement to employees and workers to help recognize and realize the value of safety
and health on the job.



Compliance Safety and Health Officers CSHO - ✔designated individuals from OSHA who
could inspect your facility for one of five reasons:
1. Employee complaints
2. Fatalities
3. Routine inspections for High Hazard
4. Catastrophes (3 or more hospitalized)
5. General inspections (Rare)

,OSHA Penalties and Fines - ✔up to $7,000 for each violation



OSHA bloodborne: Exposure Control Plan (ECP) - ✔At a minimum the ECP is reviewed
and updated annually to reflect new or modified tasks and procedures with potential
exposure.



Personal Protective Equipment PPE - ✔Should be provided to employees in appropriate
sizes at no cost and is readily accessible ex. gloves S, M, L



Hepatitis B Vaccination - ✔Offered to all employees at risk of occupational exposure at no cost.
Vaccines should be given after training and within 10 working days of initial assignment.

Those employees who initially decline, but request the vaccine at a later time are provided the
vaccine within 10 days of the request.



Recordkeeping - ✔Training records contain the dates of training, sessions, summary of
training, names and qualifications of the trainers, names and job titles of the trainees and are
maintained for 3 years.



Medical Records are kept for... - ✔duration of employment, plus 30 years thereafter.



OSHA Illness and Injury and Sharps Logs - ✔for employers with 11 or more employees at
any time in the previous year, forms should be kept for 5 years from year represented.



Automated Reviews RAC Audit - ✔when there is certainty that an overpayment or
underpayment exists, but there is no written policy, article or guideline. For example,
duplicate claims or pricing mistakes.



Complex Reviews RAC Audit - ✔RACs will make claim determinations utilizing a "human
review" of the relevant medical records and there is high probability that the service is
not covered by Medicare policy or coding guideline exists.

, Administrative Simplification - ✔Provisions of HIPPA mandate that the federal government
adopt national standards for the electronic exchange, storage and handling of health care
data between health care payers, plans and providers.



Fair Labor Standards Act (FLSA) - ✔requires employers to keep records on wages and
hours worked.



Payroll Violation - ✔Willful violation can carry a fine up to $10,000



Exempt - ✔paid salary. ex. Administrative assistants, personnel directors, office managers,
and laboratory supervisors.



Non-exempt - ✔meet requirements for overtime pay. After working there 40 hours a week
and will get pay one and a half times there regular pay. ex. Nurse aides, LPN, Janitors,
Clerical work, Lab tech assistants.



Training Records - ✔retain for 3 years.



Wage records - ✔retain for two years



Posters required to post by employers under federal law.. - ✔Age Discrimination
Child Labor
Family and Medical Leave
Polygraph Testing
Safety Requirements



Sexual Harassment - ✔consists of making an employee "uncomfortable" in the
workplace based on sex.

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