CCM - Certified Case Manager Healthcare Regulations and Compliance Questions and Answers 3

Question 1

What is the False Claims Act and why is it relevant to case managers?

Accepted Answer

A federal law imposing liability for false claims to the government, with whistleblower protections

Answer

The FCA imposes liability for submitting false claims and includes qui tam whistleblower provisions.

Question 2

Under the ADA, what constitutes a 'reasonable accommodation'?

Accepted Answer

A modification enabling a qualified person with a disability to perform essential functions without undue hardship

Answer

A reasonable accommodation enables performance of essential job functions without causing undue hardship to the employer.

Question 3

What is the purpose of the Patient Self-Determination Act?

Accepted Answer

Requiring facilities to inform patients of their rights to make care decisions and create advance directives

Answer

The PSDA requires facilities to inform patients about their decision-making rights and advance directives.

Question 4

What compliance obligation does the HITECH Act impose?

Accepted Answer

Strengthens HIPAA with increased penalties and breach notification requirements

Answer

HITECH strengthened HIPAA enforcement with increased penalties and mandatory breach notification.

Question 5

What is the role of the OIG in healthcare compliance?

Accepted Answer

Investigates fraud, waste, and abuse and issues compliance guidance

Answer

The OIG detects and prevents fraud in federal healthcare programs and issues compliance guidance.

CCM - Certified Case Manager Exam Practice Test