CPCO EXAM STUDY GUIDE QUESTIONS
AND ANSWERS
ABC Provider Group and Apple Medical Group agree to pool their resources for the
purpose of accomplishing a specific task. This is called _____________. - ANSWER-Joint
ventures
The following is not a level of non-compliance: - ANSWER-Mistake in billing
For potential criminal violations, a practice should have immediate discussions with a
criminal attorney who - ANSWER-Is well versed in Healthcare Fraud and Abuse law
The Compliance Officer's main two responsibilities are to ____________the
practice/organization's compliance program. - ANSWER-develops and then implement
Judy is the Compliance Officer for Apple Medical Group. The providers of the group ask
Judy to design a new Compliance Plan. Should Judy ask some other practices in town for a
copy of their Compliance Plan? Do all Compliance Programs have to be the same
regardless of the practice size or specialty? Why? - ANSWER-No, compliance programs
need to be tailored to fit the unique needs of every organization or physician practice
USSC is important as it related to the Federal Sentencing Guidelines and thus related to the
core elements of compliance. What does the USSC acronym stand for? - ANSWER-United
States Sentencing Commission
Kathy, the Compliance Officer at a small provider office, is notified that a non-English
speaking patient will be arriving today. A LEP person/patient who needs an interpreter to
translate to and from the person's primary language must be provided. - ANSWER-at no
cost to the patient or insurance carrier
In addition to hospitals, what other type of facility did the OIG provide supplemental
compliance program guidance for? - ANSWER-Nursing Facilities
What is (are) considered a significant element(s) in fraud? - ANSWER-Knowingly and Intent
Department of Labor requires compliance with employee and employer laws including: -
ANSWER-FLSA, OSHA, CRA, ERISA
Which government branch was created to fight waste, fraud and abuse in all federal health
care programs especially Medicare, Medicaid? - ANSWER-Office of Inspector General
(OIG)
It is important to educate employees of the methods they may utilize to directly notify and
communicate issues of suspected areas of non-compliance. What is considered a best
practice method of anonymous reporting? - ANSWER-intra-office or USPS mail
Tim at XYZ wants to conduct a baseline audit to help determine? - ANSWER-areas of the
billing department that might be in compliance
, When the term Open Door Policy is used in reference to the Effective Communication, what
is this referring to? - ANSWER-The Compliance Officer is accessible to all employees via
many methods of communication
When Kim from ABC Provider Group is conducting a risk assessment, one of the most
important and key sources of information that a Kim as the Compliance Officer should
utilize is_____________. - ANSWER-the Office of Inspector General's Annual Work Plan
The mission statement of the healthcare organization and a statement of why they are in
business are also known as _________? - ANSWER-The Code of conduct
How often should the Tim, Compliance Officer for XYZ Community Hospital update the
compliance program and plan? - ANSWER-As laws and regulations change; and at least
annually
After an employee receives their initial training regarding the practice/organization
Compliance Program what is the next step the compliance officer should take to protect the
practice against potential noncompliance activity? - ANSWER-Perform a baseline
assessment of the employee's competency scores to determine if additional training is
required
Dr. X is a very through provider. He always runs a full blood panel on each patient every
year for their physical. This is an example of: - ANSWER-Waste
The current strategy for the DOJ includes all of the following except: - ANSWER-Ensure the
privacy of patient records with the use of HIPAA
Which options are key elements for an effective Compliance Program?
I. Conducting external auditing and monitoring.
II. Implementing compliance and practice standards.
III. Designating a Compliance Officer or contact.
IV. Outsourcing appropriate training and education.
V. Responding appropriately to detected offenses and developing and implementing
corrective action.
VI. Developing open lines of communication.
VII. Enforcing disciplinary standards through well-publicized guidelines. - ANSWER-II, III, V-
VII
CPUP) The first large fraud case that involved a teaching hospital where Residents and
Fellows worked was located in: - ANSWER-Pennsylvania
The Office of Evaluation and Inspections is part of what Agency or Department? -
ANSWER-OIG
The hospital that John works for was just issued a CIA. What is the typical - ANSWER-five
years
Kathy is thinking about specializing in healthcare compliance. Which entities below must
have a OIG compliance plan? - ANSWER-a.
AND ANSWERS
ABC Provider Group and Apple Medical Group agree to pool their resources for the
purpose of accomplishing a specific task. This is called _____________. - ANSWER-Joint
ventures
The following is not a level of non-compliance: - ANSWER-Mistake in billing
For potential criminal violations, a practice should have immediate discussions with a
criminal attorney who - ANSWER-Is well versed in Healthcare Fraud and Abuse law
The Compliance Officer's main two responsibilities are to ____________the
practice/organization's compliance program. - ANSWER-develops and then implement
Judy is the Compliance Officer for Apple Medical Group. The providers of the group ask
Judy to design a new Compliance Plan. Should Judy ask some other practices in town for a
copy of their Compliance Plan? Do all Compliance Programs have to be the same
regardless of the practice size or specialty? Why? - ANSWER-No, compliance programs
need to be tailored to fit the unique needs of every organization or physician practice
USSC is important as it related to the Federal Sentencing Guidelines and thus related to the
core elements of compliance. What does the USSC acronym stand for? - ANSWER-United
States Sentencing Commission
Kathy, the Compliance Officer at a small provider office, is notified that a non-English
speaking patient will be arriving today. A LEP person/patient who needs an interpreter to
translate to and from the person's primary language must be provided. - ANSWER-at no
cost to the patient or insurance carrier
In addition to hospitals, what other type of facility did the OIG provide supplemental
compliance program guidance for? - ANSWER-Nursing Facilities
What is (are) considered a significant element(s) in fraud? - ANSWER-Knowingly and Intent
Department of Labor requires compliance with employee and employer laws including: -
ANSWER-FLSA, OSHA, CRA, ERISA
Which government branch was created to fight waste, fraud and abuse in all federal health
care programs especially Medicare, Medicaid? - ANSWER-Office of Inspector General
(OIG)
It is important to educate employees of the methods they may utilize to directly notify and
communicate issues of suspected areas of non-compliance. What is considered a best
practice method of anonymous reporting? - ANSWER-intra-office or USPS mail
Tim at XYZ wants to conduct a baseline audit to help determine? - ANSWER-areas of the
billing department that might be in compliance
, When the term Open Door Policy is used in reference to the Effective Communication, what
is this referring to? - ANSWER-The Compliance Officer is accessible to all employees via
many methods of communication
When Kim from ABC Provider Group is conducting a risk assessment, one of the most
important and key sources of information that a Kim as the Compliance Officer should
utilize is_____________. - ANSWER-the Office of Inspector General's Annual Work Plan
The mission statement of the healthcare organization and a statement of why they are in
business are also known as _________? - ANSWER-The Code of conduct
How often should the Tim, Compliance Officer for XYZ Community Hospital update the
compliance program and plan? - ANSWER-As laws and regulations change; and at least
annually
After an employee receives their initial training regarding the practice/organization
Compliance Program what is the next step the compliance officer should take to protect the
practice against potential noncompliance activity? - ANSWER-Perform a baseline
assessment of the employee's competency scores to determine if additional training is
required
Dr. X is a very through provider. He always runs a full blood panel on each patient every
year for their physical. This is an example of: - ANSWER-Waste
The current strategy for the DOJ includes all of the following except: - ANSWER-Ensure the
privacy of patient records with the use of HIPAA
Which options are key elements for an effective Compliance Program?
I. Conducting external auditing and monitoring.
II. Implementing compliance and practice standards.
III. Designating a Compliance Officer or contact.
IV. Outsourcing appropriate training and education.
V. Responding appropriately to detected offenses and developing and implementing
corrective action.
VI. Developing open lines of communication.
VII. Enforcing disciplinary standards through well-publicized guidelines. - ANSWER-II, III, V-
VII
CPUP) The first large fraud case that involved a teaching hospital where Residents and
Fellows worked was located in: - ANSWER-Pennsylvania
The Office of Evaluation and Inspections is part of what Agency or Department? -
ANSWER-OIG
The hospital that John works for was just issued a CIA. What is the typical - ANSWER-five
years
Kathy is thinking about specializing in healthcare compliance. Which entities below must
have a OIG compliance plan? - ANSWER-a.
