CPCO PRACTICE EXAM QUESTIONS
WITH CORRECT ANSWERS
What is considered an appropriate start to implementing an effective compliance
program for small physician group practices with limited resources? - ANSWER-Adopt
only those components which, based on the practice's specific history with billing
problems and other compliance issues, are most likely to provide an identifiable benefit.
OIG Compliance Program Guidance acknowledges patient care as: - ANSWER-The
first priority of a physician practice.
Because of the changing nature of healthcare regulation, the compliance program ... -
ANSWER-Is a "work in progress."
When do we need an outside consultant and/or legal counsel? - ANSWER-There is no
requirement to hire a consultant or counsel; however, having assistance from one or
both may be beneficial during certain phases or development and/or if issues arise.
What should not be ignored and may require necessary policy measures to prevent
avoidable recurrence? - ANSWER-Risk areas
What third-party plays a critical role in accurate billing and reimbursement? - ANSWER-
Billing agencies
What should be readily accessible to all coding staff? - ANSWER-All essential coding
resources
Why should compliance officers set disciplinary policies for non-compliance? -
ANSWER-Employees should know the consequences for non-compliance of set
policies.
A billing company's written policies and procedures should reflect current: - ANSWER-
Federal and state statutes
How many states currently require nursing facilities to perform a background check of
state records for direct-access employees? - ANSWER-43
How many states require nursing facilities to perform FBI checks on employees? -
ANSWER-10
SNFs are Medicare certified facilities that provide skilled nursing or rehabilitative care
under Medicare Parts: - ANSWER-A & B
, What can providers review that will help them understand the compliance requirements
of a clinical lab? - ANSWER-OIG's Clinical Lab Guidance
What law does not require that nursing facilities conduct state FBI criminal background
checks? - ANSWER-Federal law
The Affordable Care Act requires providers to refund an overpayment to Medicare
within how many days of identification? - ANSWER-60
In a qui tam action, the relator is entitled to receive a monetary settlement between: -
ANSWER-15-30%
The OIG works within which agency? - ANSWER-HHS
After hiring, how often should providers check to make sure employees are not on the
OIG List of Excluded Individuals? - ANSWER-Monthly
Under what circumstances can a relator not file or pursue a qui tam action? - ANSWER-
The qui tam action is based upon information that has been disclosed to the public
The government already is party to a civil or administrative money proceeding
What are designated health services? - ANSWER-Clinical laboratory services
Physical therapy services
Home health services
All of the above
Routine waiver of co-pays would be considered a violation of which law? - ANSWER-
The Anti-Kickback Statute
Violation of the Stark Law occurs when ... - ANSWER-The referring physician, or an
immediate member of the referring physician's family, has a financial relationship with
the entity receiving the referral
What is the current maximum penalty amount per false claim? - ANSWER-$10,957 -
$21,916, plus three times the amount claimed for damages
If a group pays a hospital monthly rent for office space that is one-half the going rate or
fair market value, this is a violation of which regulation? - ANSWER-Anti-Kickback
Statute
Which act of 2003 gave momentum to the e-prescribing movement, and was put in
place to reduce medication errors due to illegible physician handwriting, etc? -
ANSWER-Medicare Modernization Act (MMA)
WITH CORRECT ANSWERS
What is considered an appropriate start to implementing an effective compliance
program for small physician group practices with limited resources? - ANSWER-Adopt
only those components which, based on the practice's specific history with billing
problems and other compliance issues, are most likely to provide an identifiable benefit.
OIG Compliance Program Guidance acknowledges patient care as: - ANSWER-The
first priority of a physician practice.
Because of the changing nature of healthcare regulation, the compliance program ... -
ANSWER-Is a "work in progress."
When do we need an outside consultant and/or legal counsel? - ANSWER-There is no
requirement to hire a consultant or counsel; however, having assistance from one or
both may be beneficial during certain phases or development and/or if issues arise.
What should not be ignored and may require necessary policy measures to prevent
avoidable recurrence? - ANSWER-Risk areas
What third-party plays a critical role in accurate billing and reimbursement? - ANSWER-
Billing agencies
What should be readily accessible to all coding staff? - ANSWER-All essential coding
resources
Why should compliance officers set disciplinary policies for non-compliance? -
ANSWER-Employees should know the consequences for non-compliance of set
policies.
A billing company's written policies and procedures should reflect current: - ANSWER-
Federal and state statutes
How many states currently require nursing facilities to perform a background check of
state records for direct-access employees? - ANSWER-43
How many states require nursing facilities to perform FBI checks on employees? -
ANSWER-10
SNFs are Medicare certified facilities that provide skilled nursing or rehabilitative care
under Medicare Parts: - ANSWER-A & B
, What can providers review that will help them understand the compliance requirements
of a clinical lab? - ANSWER-OIG's Clinical Lab Guidance
What law does not require that nursing facilities conduct state FBI criminal background
checks? - ANSWER-Federal law
The Affordable Care Act requires providers to refund an overpayment to Medicare
within how many days of identification? - ANSWER-60
In a qui tam action, the relator is entitled to receive a monetary settlement between: -
ANSWER-15-30%
The OIG works within which agency? - ANSWER-HHS
After hiring, how often should providers check to make sure employees are not on the
OIG List of Excluded Individuals? - ANSWER-Monthly
Under what circumstances can a relator not file or pursue a qui tam action? - ANSWER-
The qui tam action is based upon information that has been disclosed to the public
The government already is party to a civil or administrative money proceeding
What are designated health services? - ANSWER-Clinical laboratory services
Physical therapy services
Home health services
All of the above
Routine waiver of co-pays would be considered a violation of which law? - ANSWER-
The Anti-Kickback Statute
Violation of the Stark Law occurs when ... - ANSWER-The referring physician, or an
immediate member of the referring physician's family, has a financial relationship with
the entity receiving the referral
What is the current maximum penalty amount per false claim? - ANSWER-$10,957 -
$21,916, plus three times the amount claimed for damages
If a group pays a hospital monthly rent for office space that is one-half the going rate or
fair market value, this is a violation of which regulation? - ANSWER-Anti-Kickback
Statute
Which act of 2003 gave momentum to the e-prescribing movement, and was put in
place to reduce medication errors due to illegible physician handwriting, etc? -
ANSWER-Medicare Modernization Act (MMA)
