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CPCO chapter 2 - Exam Questions and Verified
Answers
When is an outside consultant and/or legal counsel necessary?
Only when an overpayment is identified.
There is no requirement to hire a consultant or counsel, but such assistance may
be beneficial during certain phases of development and/or if issues arise.
In the beginning of plan development.
Never.
Ans: There is no requirement to hire a consultant or counsel, but such
assistance may be beneficial during certain phases of development and/or if
issues arise.
There is no requirement that outside consultants or legal counsel be
involved in a Compliance Program. However, during certain phases of
program development and implementation, both consultants and legal
counsel may be beneficial.
Most expenses related to developing and implementing a compliance program
are considered the cost of doing business and are tax deductible for the
organization. Which, of the following, is NOT tax deductible?
when the expense costs are more than the national average
when the expenses are a result of the imposition of a penalty
for the annual maintenance of the program
except the salary of the Compliance Officer
Ans: when the expenses are a result of the imposition of a penalty
A CIA is a penalty imposed upon the organization and, as with any other
governmental penalty, the expense of the development, implementation, and
maintenance of this program cannot be included as a deductible expense to
the organization.
What is the most important aspect of a Compliance Program?
Training
Implementation
Development
Discipline
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Ans: Implementation
Without adherence to the stated goals and objectives there is no purpose to
the document itself. Having all the components of a compliance program in
place will not matter if they are not implemented.
Fraud, waste, and abuse are all areas that must be controlled when providing
services to beneficiaries. Which statement is TRUE regarding fraudulent billing?
A series of errors is considered fraudulent billing.
Fraudulent billing is only an issue if the erroneous billing is identified and not
resolved.
Fraudulent billing only occurs when refunds are not issued in a timely manner.
Fraudulent billing is a willful act with intent to receive payment for services not
rendered.
Ans: Fraudulent billing is a willful act with intent to receive payment for
services not rendered.
Fraudulent billing is willful, and is undertaken with the intent to receive
payment for services not legitimately rendered.
Because of the changing nature of healthcare regulation, which statement is
TRUE regarding the compliance program?
The compliance program should only be updated annually to ensure all the
changed regulations are captured.
The compliance program should be updated biannually.
Hiring a consultant to review the program for accuracy is necessary.
The compliance program should be continually a work in progress.
Ans: The compliance program should be continually a work in progress.
The program should be monitored and updated at least annually, and more
likely more often, to provide for up-to-date compliance.
Which statement is true regarding compliance programs?
Compliance programs are not mandated by law.
Compliance programs are only effective after the baseline audit has been
performed and policies written.
Compliance programs are only required by law for healthcare entities that have
more than $500,000 in annual revenue.
Compliance programs are considered more dangerous if they are developed but
not implemented.
CPCO chapter 2 - Exam Questions and Verified
Answers
When is an outside consultant and/or legal counsel necessary?
Only when an overpayment is identified.
There is no requirement to hire a consultant or counsel, but such assistance may
be beneficial during certain phases of development and/or if issues arise.
In the beginning of plan development.
Never.
Ans: There is no requirement to hire a consultant or counsel, but such
assistance may be beneficial during certain phases of development and/or if
issues arise.
There is no requirement that outside consultants or legal counsel be
involved in a Compliance Program. However, during certain phases of
program development and implementation, both consultants and legal
counsel may be beneficial.
Most expenses related to developing and implementing a compliance program
are considered the cost of doing business and are tax deductible for the
organization. Which, of the following, is NOT tax deductible?
when the expense costs are more than the national average
when the expenses are a result of the imposition of a penalty
for the annual maintenance of the program
except the salary of the Compliance Officer
Ans: when the expenses are a result of the imposition of a penalty
A CIA is a penalty imposed upon the organization and, as with any other
governmental penalty, the expense of the development, implementation, and
maintenance of this program cannot be included as a deductible expense to
the organization.
What is the most important aspect of a Compliance Program?
Training
Implementation
Development
Discipline
, Page | 2
Ans: Implementation
Without adherence to the stated goals and objectives there is no purpose to
the document itself. Having all the components of a compliance program in
place will not matter if they are not implemented.
Fraud, waste, and abuse are all areas that must be controlled when providing
services to beneficiaries. Which statement is TRUE regarding fraudulent billing?
A series of errors is considered fraudulent billing.
Fraudulent billing is only an issue if the erroneous billing is identified and not
resolved.
Fraudulent billing only occurs when refunds are not issued in a timely manner.
Fraudulent billing is a willful act with intent to receive payment for services not
rendered.
Ans: Fraudulent billing is a willful act with intent to receive payment for
services not rendered.
Fraudulent billing is willful, and is undertaken with the intent to receive
payment for services not legitimately rendered.
Because of the changing nature of healthcare regulation, which statement is
TRUE regarding the compliance program?
The compliance program should only be updated annually to ensure all the
changed regulations are captured.
The compliance program should be updated biannually.
Hiring a consultant to review the program for accuracy is necessary.
The compliance program should be continually a work in progress.
Ans: The compliance program should be continually a work in progress.
The program should be monitored and updated at least annually, and more
likely more often, to provide for up-to-date compliance.
Which statement is true regarding compliance programs?
Compliance programs are not mandated by law.
Compliance programs are only effective after the baseline audit has been
performed and policies written.
Compliance programs are only required by law for healthcare entities that have
more than $500,000 in annual revenue.
Compliance programs are considered more dangerous if they are developed but
not implemented.
