CHC Compliance Program Administration 3

Question 1

Which document outlines the standards of conduct and ethical expectations for all employees in a healthcare organization's compliance program?

Accepted Answer

The code of conduct

Answer

The code of conduct establishes the organization's ethical standards and behavioral expectations that all employees are required to follow.

Question 2

A compliance officer at a large health system wants to benchmark the organization's compliance program. Which is the MOST credible benchmarking resource?

Accepted Answer

HCCA/OIG Healthcare Compliance Program Effectiveness Resource Guide

Answer

The HCCA/OIG Healthcare Compliance Program Effectiveness Resource Guide provides authoritative benchmarks and practices for evaluating compliance programs.

Question 3

What does 'tone at the top' refer to in the context of healthcare compliance?

Accepted Answer

Leadership's demonstrated commitment to ethical behavior and compliance

Answer

Tone at the top refers to the culture of integrity set by senior leadership, which significantly influences employee compliance behavior throughout the organization.

Question 4

In a Corporate Integrity Agreement (CIA), what is the role of the Independent Review Organization (IRO)?

Accepted Answer

To conduct independent reviews of claims and practices as required by the CIA

Answer

An IRO conducts independent, objective reviews of the organization's billing, coding, and other practices as specified in the CIA to verify compliance.

Question 5

Which of the following scenarios BEST illustrates a conflict of interest that a compliance officer should address?

Accepted Answer

A physician who refers patients to a physical therapy clinic in which they have a financial interest

Answer

A physician referring patients to a facility in which they have a financial interest represents a classic conflict of interest and potential Stark Law violation.

CHC - Certified in Healthcare Compliance Practice Test

CHC - Certified in Healthcare Compliance Practice Test

CHC Compliance Program Administration 3