COCO SOLUTIONS ACADEMIC STORE

True or False: Under the False Claims Act, "knowing" means only having actual knowledge. - Answer False Which of the following is not an element of an effective compliance program? - Answer Ignoring unethical conduct All of the following billing activities are considered fraudulent, EXCEPT: - Answer Submitting bills for goods or services as provided A vendor tells you that you have won an all-expense paid trip to the Bahamas no strings attached. What should you do? ...

Corporate Compliance Program(CCP) - Answer a formal, organizational-specific, and organization-wide initiative designed to uncover, prevent, and eliminate inappropriate activity in your health organization fraud and abuse - Answer with a CCP a facility will be able to detect? Benefits of a CCP - Answer -demonstrate commitment -provide accurate view of behavior relating to fraud and abuse -ID & prevent criminal & unethical conduct -improve quality of patient care -create...

Seven Elements of an Effective Compliance Program - Answer (1) Standards, Policies, and Procedures (2) Compliance Program Administration (3) Communication, Education, and Training (4) Monitoring and Auditing (5) Internal Reporting Systems (6) Discipline for Noncompliance (7) Investigation and Remediation Measures Effective Compliance and Ethics Program Components (Not All-Inclusive) - Answer (1) Code of conduct and relevant compliance policies and procedures (2) Oversight and...

"...it cannot be emphasized enough that the only thing worse than not having a policy is having a policy and not following it." This statement refers to which of the 7 Compliance Program Elements" a. code of conduct b. compliance administration (Officer/Committee) c. education d. monitoring and auditing e. reporting and investigating f. enforcement and discipline g. response and prevention - Answer a. code of conduct What demonstrate the organization's ethical attitu...

Compliance Program Check Your Knowledge Who is primarily responsible for administration of the compliance program at GMR ? - Answer Chief Financial Officer Centers for Medicare & Medicaid Services U.S. Department of Health and Human Services Office of Inspector General ( HHS - OIG ) Ethics & Compliance Department Ethics & Compliance Department Code of Conduct & Duty to Report Check Your Knowledge Which of the following types of conduct must be reported to the GMR Ethics & Comp...

Compliance Programs demonstrate our good faith effort to fulfill our legal duty and eliminate improper or unethical conduct. Which of the following is not part of a Compliance Program's purpose? - Answer Increase rev Use the drop-downs to match each Element of an Effective Compliance Program to its description. - Answer Policies & proc.: clearly written Oversight: chief Training & Ed: topical instructions Lines of comm: routes used Auditing: comprehensive risk assessments...

Who is responsible for enforcing compliance? - Answer The HHS Office of the Inspector General (OIG) in conjunction with the Justice Department is responsible for enforcing the rules and regulations under the Medicare and Medicaid laws outlined by the Social Security Act and administered by the Centers for Medicare and Medicaid Services (CMS) Benefits of a Compliance Program - Answer 1. safeguards the organization's legal responsibility to abide by the applicable laws and regulati...

What two documents does our book state as the tools with which you can begin to build your compliance program? - Answer the standards or code of conduct and the policies and procedures Our reading states the Code of Conduct is a process for what? - Answer proper decision-making, for doing the right thing What are the 5 parts of COC checklist? - Answer Code of Conduct: Content Checklist Reflects cultures and values of the organization Written plainly and concisely so all em...

Compliance Program - Answer following rules and regulations Integrity Program - Answer values and doing the right thing Current Compliance activities in many organization - Answer o Equal Employment Opportunity Commission (EEOC) o Employee Retirement Income Security Act (ERISA) o Wage and Hour Rule o Occupational Safety and health Administration (OSHA) o Nuclear Regulatory Commission o Joint Commission on Accreditation of Healthcare Organization (JCAHO) o Research com...

Why an MLS? - Answer provides a framework for data integrity offers blanket, unilateral offers of compensation In house sales are under 25% Fuels cooperation, Cooperation fuels business Why listing compliance? - Answer By understanding the rules and regulations, we ensure that we have better data for everyone. Violations can be costly to your business and the business of others. Adhering to the rules ensures that everyone is on the same page and gives us the best tools for ou...

Why develop a compliance program? - Answer Promotes a culture of ethical behavior and commitment to compliance with the law. Aids in preventing and detecting wrong doing Provides safe mechanisms for reporting and seeking help in getting it right the first time Raises awareness of organizations expectations Positive impact to corporate reputation/cultures public image Compliance program influence - Answer 1970: bank corruption 1980: defense fraud 1990: health care fraud/oig f...

Anti-kickback statute - Answer Prohibits the solicitation, receiving, offering or paying of any renumeration directly or indirectly in cash or in kind in exchange. Stark Law - Answer Prohibits a physician from making referrals of Medicare and Medicaid patients for the furnishing of certain designated health services with which the physician has a financial relationship. Statistical sampling - Answer The practice of making statements regarding the characteristics of a large p...

The Seven Essential Elements of an Effective Compliance Program - Answer 1.Standards (Code) of Conduct/Policies and Procedures 2. Compliance Officer and Compliance Committee (establishing compliance oversight) 3. Education (conducting effective training and education) 4. Monitoring and Auditing 5. Reporting and Investigating (developing effective lines of communication and screening) 6. Enforcement and Discipline (enforcing standards through well-publicized disciplinary guidelines) 7....

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Knowingly do not care for a PT: This is refusing the PT access to care. - Answer What is deliberate indifference? Landmark Case Estelle vs Gamble 1976. - Answer Access to care is directly related to Juveniles: - Answer With this group You are not allowed to assess the co-pays for medical sick calls. security regulations - Health staff has to abide by the security regulations. - Answer Health Staff & Security: Health staff will need to be oriented about the Corre...

HIPAA became law - Answer 1996 What is the purpose of HIPAA? - Answer • To make health insurance portable under ERISA; • To move health care onto a nationally standardized electronic billing platform; and • To prevent fraud, waste and abuse Intent - Answer purpose of this subtitle to improve the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, and the efficiency and effectiveness of the health care sys...

A compliance professional is trying to determine if attorney client privilege should be requested. The compliance professional's policy should require attorney-client privilege to be established in which of the following situations: a. Violation of employee that occurred outside of the organization, and not within the roles and responsibilities this employee has to the organization. b. Illegal or unethical business practices by a Chief Executive Officer or other Executive Management. c....

True or False: The ACA requires that all providers adopt a compliance plan as a condition of enrollment with Medicare, Medicaid, and Children's Health Insurance Program (CHIP). - Answer True ref. ACA section 6102 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - Answer 1.Protect our programs 2.Protect your patients 3.Protect the Provider At which level of the Medicare Part A or Part B appeals process i...

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There are three lists that drivers, shippers and carriers use to find out if a material is regulated as hazardous. Which one of there choices is not one of those three lists? - Answer epa dangerous materials list Drivers of placarded vehicles transporting hazardous materials must stop ____ to ____ feet from the nearest rail of a railroad. - Answer 15 to 20 feet How many identical placards is a vehicle hauling hazardous materials required to display and where? - Answer Four (...