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CHC EXAM PREP ACTUAL EXAM 2024 WITH COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ $27.99
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CHC EXAM PREP ACTUAL EXAM
2024 WITH COMPLETE QUESTIONS
AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
What should you do if HHS, OIG, DOJ or FBI show up for an investigation? - <<ANSWERS>>1.
Communicate to all.
2. Let Legal Counsel know immediately.
3. Review documents provided (subpoenas).
4. Compliance Officer should be present to document all.
If misconduct is found, enforcement and discipline should follow. Enforcement should start with
your Code of Conduct and P&PS.
Enforcement & Discipline Policy should state: - <<ANSWERS>>* Non-compliance will be punished.
* Failure to report non-compliance will be punished.
* A set of disciplinary procedures will be followed.
* Certain parties are responsible for appropriate action.
* Discipline will be fair and consistent.
List the steps of a typical disciplinary action chain: - <<ANSWERS>>1. Verbal warning.
2. Written warning.
3. Suspension.
4. Fine(s).
5. Termination.
Name 4 entities of the U.S. Department of Health & Human Services. - <<ANSWERS>>1. Centers for
Medicare & Medicaid Services (CMS).
, 2. Office of Inspector General (OIG).
3. Office of the National Coordinator for Health Information Technology (ONC).
4. Office for Civil Rights.
What does CMS do? - <<ANSWERS>>Administers Medicare and Medicaid, the Children's Health
Insurance Program (CHIP), and the Health Insurance Marketplace.
What does the OIG do? - <<ANSWERS>>Provides oversight of Medicare and Medicaid and related
healthcare fraud and abuse monitoring and enforcement.
What does the ONC do? - <<ANSWERS>>Provides support for interoperable, private, and secure
nationwide health information systems.
What is the Federal Trade Commission (FTC) and what do they monitor in healthcare. -
<<ANSWERS>>The FTC promote and educates consumers about and protects them from unfair
business practices.
In healthcare, they monitor pharmaceutical drug pricing and competition.
What is the New York Stock Exchange (NYSE)? - <<ANSWERS>>Where companies raise capital used
to shape their future.
What is the False Claims Act? When was it amended? - <<ANSWERS>>-Legislation that prohibits
anyone from knowingly submitting or causing to be submitted a false or fraudulent claim.
-It allows individuals to file lawsuits on behalf of the U.S. Government and may receive a portion of
the government's recovery.
-1986.
What are the U.S Federal Sentencing Guidelines?
When was the Federal Sentencing Commission Organized?
When were the Guidelines first published?
,When were the Guidelines Amended?
And what did the amendment include? - <<ANSWERS>>Guidelines developed by the US. Federal
Sentencing Commission that set out a uniform policy for sentencing individuals and organizations of
felonies and serious misdemeanors.
- 1985.
- Published in 1987.
-Amended in 1991 - Included 7 elements of a Compliance Program.
What Chapter of the U.S Federal Sentencing Guidelines focuses on compliance programs for
organizations? - <<ANSWERS>>Chapter 8.
What are the 7 elements of a compliance program? - <<ANSWERS>>1. Policies & Procedures.
2. Program Administration - Compliance Officer & Committee.
3. Training & Education.
4. Effective Lines of Communication.
5. Internal Monitoring & Auditing.
6. Disciplinary Guidelines.
7. Corrective Action.
What is a Corporate Integrity Agreement? - <<ANSWERS>>A negotiated settlement between an
organization and the government in which the provider accepts no liability but must agree to
implement a strict plan of government-supervised corrective action.
What is the Health Care Fraud and Abuse Control Program?
When was it established?
What law mandated its creation? - <<ANSWERS>>It's a program that coordinates federal, state, and
local law enforcement activities to combat fraud and abuse in the healthcare sector.
1997.
HIPAA.
, HHS OIG issued "Practical Guidance for Health Care Governing Boards on Compliance Oversight" in
what year?
What law outlined the use of exclusion from federal health programs? - <<ANSWERS>>2015.
Social Security Act.
OIG and HCCA issued "Measuring Compliance Program Effectiveness - A Resource Guide" in what
year? - <<ANSWERS>>2017.
What are the benefits of a compliance program? - <<ANSWERS>>* Good corporate conduct and
quality of care.
* Protects patient rights and privacy.
* Detects criminal and unethical conduct.
* Centralized resource for info. on healthcare regulations.
* Encourages reporting w/o retaliation.
* Allows for prompt/thorough investigations.
* Initiates in RCAs and CAPs. * Reduces exposure to:
-civil damages and penalties
-sanctions
-administrative remedies.
-CIAs and government exclusions
Why are effective compliance programs essential? - <<ANSWERS>>1. Protect the organization's
reputation.
2. "Doing the right thing."
3. Raise awareness - employees can report anonymously.
4. Keeps employees accountable.
5. Detect non-compliance early and reduce risk of fines and penalties.
More reasons to implement a compliance program! - <<ANSWERS>>* Demonstrate commitment to
honesty/corporate citizenship.
* Cost-effective.
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