QUESTIONS WITH COMPLETE SOLUTIONS GUARANTEED
PASS
After an investigation, it was discovered that the organization's
reputation is at stake. What should a Compliance Professional do next?
A. Report the findings to the board
B. Contact legal counsel
C. Advise the CEO and recommend next steps
D. Self-disclose to the OIG - CORRECT ANSWER>>B. Contact legal
counsel
The compliance officer has completed the non-retaliation policy
and it's been officially implemented. The next steps should be:
a. Investigate all reports of violations
b. Post the information publicly in the internet
c. Make the information available to hospital employees
d. Revise it annually - CORRECT ANSWER>>c. Make the information
available to hospital employees
If during the course of an internal investigation, the compliance officer
believes the integrity of the investigation might be compromised by the
,continued presence of work force members who are the subject of the
investigation. In the best interest of the attorney-client privilege, which
action would you take?
a. Conduct employee background checks
b. Counsel obtains employee's depositions
c. Destroy documents and other evidence
d. Re-assign employees to other responsibilities until the investigation is
completed
e. All of the above - CORRECT ANSWER>>d. Re-assign employees to
other responsibilities until the investigation is completed.
Explanation: he/she should recommend that such individuals be
temporarily removed from their current responsibilities until the
investigation is completed.
Ref. Healthcare Compliance Professional's Manual
The privacy officer for a hospital has updated the Notice of Privacy
Practices to reflect a material change because the previous notice did
not have a description that individuals have the right to amend their
Protected Health Information. The third party review team identified
that the notice did not have the required information to let individuals
know of their right to amend PHI.
What's the BEST course of action to correct deficiency?
A. Make arrangements to have copies of the new NPP mailed to all
patients seen within the last year at the hospital
B. Make arrangements to have the new notice distributed to new
patients that come to the hospital
,C. Post a copy of the new notice on the hospital's internal intranet so
that all employees can see the updated version of the notice
D. Meet with legal to discuss how to best self-disclose to the OCR
that the hospital was in violation of the NPP requirements and has
since c - CORRECT ANSWER>>B. Make arrangements to have the new
notice distributed to new patients that come to the hospital
The NPP must describe the following individual rights:
https://www.law.cornell.edu/cfr/text/45/164.520
• The right to request restrictions on uses or disclosures of PHI for
treatment, payment or healthcare operations; for use in a facility
directory (if applicable); or to family members and others involved in
the patient's care; however, the provider is not required to agree to
the restriction except in the case of a disclosure to a health insurer if
the individual has paid for the care as required by
§164.522(a)(1)(vi). This is a change necessitated by the Omnibus Rule.
• The right to receive confidential communications by alternative means
or at alternative locations per §164.522(b).
• The right to inspect and copy PHI per § 164.524. The provider may
want to include a statement that the provider may charge a
reasonable cost-based fee for copies.
• The right to amend PHI per § 164.526.
• The right to receive an accounting of disclosures of PHI as provided by
§ 164.528.
• The right to receive a paper copy of the NPP upon request.
• A brief description of how the individual may exercise the foregoing
rights, e.g., by submitting a written request to the provider's privacy
officer.
, The billing manager was conducting a contemporaneous review and
found what could be a significant error. The billing manager contacts
you and you then subsequently contact your inhouse legal counsel.
Which of the following statements are False?
a. Because of the False Claims Act, your in-house counsel advises
you that the retrospective audit will need to cover a minimum of 6
years to a maximum of 10 years.
b. If you do not refund the Medicare overpayments, you could be
charged with a federal felony under the Social Security Act.
c. A contemporaneous review that was done by the billing manager
would be covered under the attorney-client privilege.
d. You are asked to perform a statistical sample of the population.
You need to know that a larger sample size will be required if the
variation in the errors is larger. - CORRECT ANSWER>>c. A
contemporaneous review that was done by the billing manager would
be covered under the attorney-client privilege.
Explanation: A significant limitation of the definition of protected
communications relates to documents that are prepared by the client
prior to the time when the attorney began preparations to give advice.
Ref. Healthcare Compliance Professional's Manual
You are the new compliance officer at an institution with an already
established compliance committee. Which committee members'
professional background would be MOST valuable in performing
audit activities? a. Legal Counsel
b. Business Management
c. Chief Financial Officer
d. Bio-Medical Engineer - CORRECT ANSWER>>b. Business Management