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CPMA Chapter 1, Questions and answers, 100% Accurate, rated A
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CPMA Chapter 1, Questions and answers, 100% Accurate, rated A Stark Law - -Physician Self Referral Law Prohibits a physician from making a referral to an entity with which they or their immediate family has a financial relationship if the referral is for the furnishing of designated health se...

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  • February 13, 2023
  • 4
  • 2022/2023
  • Exam (elaborations)
  • Questions & answers

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  • cpma chapter 1
  • questions and answers
  • 100 accurate
  • rated a stark law physician self referral law prohibits a physician from making a referral to an entity with which they or their immediate fa

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CPMA Chapter 1, Questions and
answers, 100% Accurate, rated A

Stark Law - ✔✔-Physician Self Referral Law

Prohibits a physician from making a referral to an entity with which they or their immediate family has a
financial relationship if the referral is for the furnishing of designated health services



RAT-STATS - ✔✔-A statistical software that is a valuable analytical tool used by auditors



Components of RAT-STATS that should be used to perform CIA Claims Review - ✔✔-"Random Numbers"
to draw random samples for both the Discovery Sample and the Full Sample

"Variable Appraisaisals" to calculate the mean & standard deviation of the overpayment amount in the
sample

"Sample Size Estimator" to estimate the size of the full sample



CIA Reportable Events - ✔✔-1. A substantial overpayment

2. A potential violation of criminal, civil, or admistrative laws

3. Filing of a bankruptcy petition



OIG Work Plan - ✔✔-Released annually and identifies priority areas for OIG review/investigation which
the agency believes are HHS' most vulnerable programs and activities. The goal is to improve HHS
agency efficiency and effectiveness.



CIA - ✔✔-Coporate Integrity Agreement - an agreement between the OIG and a health care provider or
other entity when serious misconduct (fraudulent or abusive type action) is discovered through an audit
of self-disclosure. It is detailed and restrictive.

Government can do this instead of excluding

Typical term is 5 years

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