Exam (elaborations)
CPCO STUDY GUIDE | 473 Questions with 100% Correct Answers | Latest Update 2024 | Rated A+
- Course
- Institution
CPCO STUDY GUIDE | 473 Questions with 100% Correct Answers | Latest Update 2024 | Rated A+
[Show more]
Content preview
CPCO STUDY GUIDE | 473 Questions with 100% Correct Answers| Latest Update 2024 | Rated A+
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? - ✔✔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. - ✔✔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? - ✔✔Nursing Facilities
What is (are) considered a significant element(s) in fraud? - ✔✔Knowingly and Intent
Department of Labor requires compliance with employee and employer laws including: -
✔✔FLSA, OSHA, CRA, ERISA
Which government branch was created to fight waste, fraud and abuse in all federal health
care programs especially Medicare, Medicaid? - ✔✔Office of Inspector General (OIG)
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: - ✔✔Waste
The current strategy for the DOJ includes all of the following except: - ✔✔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. - ✔✔II, III, V-VII
CPUP) The first large fraud case that involved a teaching hospital where Residents and
Fellows worked was located in: - ✔✔Pennsylvania
The Office of Evaluation and Inspections is part of what Agency or Department? - ✔✔OIG
The hospital that John works for was just issued a CIA. What is the typical - ✔✔five years
Kathy is thinking about specializing in healthcare compliance. Which entities below must have
a OIG compliance plan? - ✔✔a.
Laboratories, DME and Ambulance providers
b.
Home Health, Hospice and Nursing Homes
c.
Small and Large Provider Groups, Hospitals and Nursing Homes
Which component of the OIG has a duty of conducting audits, which result in reducing waste,
abuse, and mismanagement? - ✔✔Office of Audit Services
,Kim is the Compliance Officer for a large provider group. One of the billers for the group
enters codes from the encounter form every evening before she goes home and then finishes
in the morning when she returns. She often enters an encounter twice. She usually catches
the mistake when the insurance checks are sent to the office and returns the overpayment to
the insurance carrier. This is an example of: - ✔✔Abuse
Which OIG office conducts criminal, civil and administrative investigations of fraud
and misconduct related to HHS programs, operations and beneficiaries? - ✔✔Office of
Investigations
Dr. A hires a nurse without looking to see if she was on the OIG's Excluded List. The nurse had
committed fraud in the past and was Excluded from working with any entity or individual that
uses Federal or State funds. Which of the statements below is true? - ✔✔Dr. A will have to pay
a CMP
The OIG Five Principal Strategy is made up of the following - ✔✔Enrollment,
Payment, Compliance, Oversight and Response
According to Inspector General Daniel Levinson, what can help reduce enforcement on
a provider from a CIA to a CCA? - ✔✔a robust and effective compliance program
What does the acronym LEP stand for? - ✔✔Limited English Proficiency
John works at a large hospital in the Compliance Department. He just heard that the hospital
was issued a CIA. What does CIA stand for? - ✔✔Corporate Integrity Agreement
What year did the GAO identify Medicare claims to be at high risk for fraud and abuse which
resulted in the OIG initiating an audit of HCFA (CMS) payment system? - ✔✔1992
Dr. Smith asks you, the Compliance Officer, what is the typical term of a CCA? - ✔✔three years
, Larry is the Compliance Officer for a small hospital. A staff member of the hospital thinks that
employment discrimination has occurred. Which governmental office could give Larry more
information? - ✔✔Department of Labor
All expenses related to developing and implementing a compliance program are considered
the cost of doing business and are tax deductible for the organization, except: - ✔✔when the
expenses are a result of the imposition of a penalty.
Compliance programs are - ✔✔more dangerous if they are developed but not implemented.
Because of the changing nature of healthcare regulation, the Compliance Program -
✔✔Is continually a work in progress
What is considered an appropriate start to implementing an effective compliance program for
compliance officers of small physician group practices with limited resources? - ✔✔Adopt
only those components which, based on the practice's specific history with billing problems
and other compliance issues, are most likely to provide an identifiable benefit?
The OIG Compliance Program Guidance acknowledges patient care as: - ✔✔The first priority
of a physician practice
Payers expect all providers to refund monies that are overpayments. By law, this must occur... -
✔✔Within 60 days of identification of overpayment
There are many benefits of having an effective compliance program. One such benefit is: -
✔✔It shows that the practice is making a good faith effort to be compliant.
What is the most important aspect of a Compliance Program? - ✔✔Implementation
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Examsplug. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81989 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now