CPCO EXAM BUNDLE 2023

C. Health Care Fraud and Abuse Control Program (HCFAC) -ANSWER Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, what is the name of the national program designed to coordinate Federal, State and local law enforcement activities with respect to health...

One of the most important elements of an effective compliance program is to have a compliance officer or committee who is__________. -ANSWER empowered If an employee, provider or anyone that deals with Federal or State healthcare dollars has intent to receive payment for services not legitimatel...

Why is the annual OIG Work Plan so important to Compliance Officers when they are developing their risk assessments? -ANSWER Because it shows results of previous year's audit findings and the current year's focus. A Compliance Officer does not have to be a lawyer, but your chances of implementi...

Modifier 25 is used to allow additional payment for E/M services performed by a provider on the same day as a procedure, as long as ____________. -ANSWER The E/M services are significant, separately identifiable, and above and beyond the usual preoperative and postoperative care associated with the ...

Under EMTALA, all Medicare participating hospitals are required to provide at least a medical screening exam to a patient who comes to the emergency department ... -ANSWER regardless of the patient's insurance or ability to pay. Any laboratory performing testing on specimens derived from a human...

Audit MICs can audit a Medicaid provider throughout his or her__________. - ANSWERCountry What type of software process identifies potential claim errors? - ANSWER? Data mining What does Medicare Part D cover? - ANSWERPrescription Drugs RACs perform what type of review(s) - ANSWERAutomated...

compliance certification agreements (CCAs) require providers to certify they will continue to operate their existing compliance program for a fixed term. What is the typical term of a corporate integrity agreement (CIA)? -ANSWER three years The OIG has stated that an affective compliance plan can...

One of the most important elements of an effective compliance program is to have a compliance officer or committee who is__________. -ANSWER empowered If an employee, provider or anyone that deals with Federal or State healthcare dollars has intent to receive payment for services not legitimately...