CPCO EXAM UPDATED ACTUAL Exam
Questions and CORRECT Answers
Question 1
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? - CORRECT
ANSWER - Health Care Fraud and Abuse Control Program (HCFAC)
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: - CORRECT ANSWER - Promote an organizational
culture that encourages ethical conduct and a commitment to compliance with the law.
Question 3
If a physician practice uses another entity's standards of conduct, the practice must: - CORRECT
ANSWER - Tailor those materials to the physician practice where they will be applied.
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? - CORRECT ANSWER -
For any services billed, documentation must be present in the patient's medical record to support
the services.
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? - CORRECT ANSWER - Document the conversation and retain the records.
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: -
CORRECT ANSWER - Be sure any time frames or requirements listed can be accomplished
given the practice's resources.
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 ____________________. - CORRECT ANSWER -
Verify accuracy of coding and reimbursement for the services performed.
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? - CORRECT ANSWER - Reviewing
reports to see that new employees and vendors have been checked against the OIG's list of
excluded individuals and entities.
Question 9
For larger physician practices, how frequently does the OIG recommend reporting compliance
activities to the Board of Directors and CEO? - CORRECT ANSWER - Regularly
Question 10
When conducting compliance training within a physician practice, what is one of the goals that
the practice should strive for in this compliance training? - CORRECT ANSWER - All
employees will receive training on how to perform their jobs in compliance with the standards of
the practice and any applicable regulations.
Questions and CORRECT Answers
Question 1
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? - CORRECT
ANSWER - Health Care Fraud and Abuse Control Program (HCFAC)
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: - CORRECT ANSWER - Promote an organizational
culture that encourages ethical conduct and a commitment to compliance with the law.
Question 3
If a physician practice uses another entity's standards of conduct, the practice must: - CORRECT
ANSWER - Tailor those materials to the physician practice where they will be applied.
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? - CORRECT ANSWER -
For any services billed, documentation must be present in the patient's medical record to support
the services.
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? - CORRECT ANSWER - Document the conversation and retain the records.
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: -
CORRECT ANSWER - Be sure any time frames or requirements listed can be accomplished
given the practice's resources.
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 ____________________. - CORRECT ANSWER -
Verify accuracy of coding and reimbursement for the services performed.
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? - CORRECT ANSWER - Reviewing
reports to see that new employees and vendors have been checked against the OIG's list of
excluded individuals and entities.
Question 9
For larger physician practices, how frequently does the OIG recommend reporting compliance
activities to the Board of Directors and CEO? - CORRECT ANSWER - Regularly
Question 10
When conducting compliance training within a physician practice, what is one of the goals that
the practice should strive for in this compliance training? - CORRECT ANSWER - All
employees will receive training on how to perform their jobs in compliance with the standards of
the practice and any applicable regulations.
