CCCP Healthcare Compliance & HIPAA 3

Question 1

A patient requests an amendment to their medical record, claiming the information is inaccurate. Under HIPAA, a covered entity may deny the request if:

Accepted Answer

The PHI was not created by the covered entity

Answer

A covered entity may deny an amendment request when the PHI at issue was not created by that entity, among other grounds listed in the Privacy Rule.

Question 2

Under the Anti-Kickback Statute (AKS), which element distinguishes a safe harbor arrangement from a prohibited kickback?

Accepted Answer

Safe harbor arrangements meet specific criteria that insulate them from prosecution

Answer

AKS safe harbors define specific criteria under which remuneration arrangements will not be treated as kickbacks warranting prosecution.

Question 3

The Stark Law (Physician Self-Referral Law) prohibits a physician from referring Medicare patients for designated health services to an entity in which the physician has a financial relationship, unless:

Accepted Answer

A recognized exception applies

Answer

The Stark Law is a strict liability statute, so the only way to make a prohibited referral permissible is to fit within a statutory or regulatory exception.

Question 4

A healthcare organization's compliance program receives an anonymous hotline tip alleging billing fraud. The FIRST step the compliance officer should take is to:

Accepted Answer

Conduct a preliminary assessment to determine whether the allegation has merit

Answer

A compliance officer should first conduct a preliminary assessment to evaluate the credibility and scope of the allegation before escalating or taking remedial action.

Question 5

Under the False Claims Act (FCA), the 'reverse false claim' theory imposes liability when a defendant:

Accepted Answer

Knowingly retains an overpayment from a government health program

Answer

A reverse false claim arises when a party knowingly retains money owed to the government, such as a Medicare overpayment, rather than repaying it.

(CCCP) Certified Corporate Compliance Professional Practice Test

(CCCP) Certified Corporate Compliance Professional Practice Test

CCCP Healthcare Compliance & HIPAA 3