CHC Compliance Risk Assessments 2 — Questions and Answers
Question 1: Which tool is most commonly used to prioritize risks identified during a healthcare compliance risk assessment?
- Risk heat map (Correct answer)
- Gantt chart
- SWOT analysis
- Flowchart diagram
Correct answer: Risk heat map
A risk heat map plots likelihood against impact to visually prioritize which risks require the most urgent attention.
Question 2: In a compliance risk assessment, 'inherent risk' refers to:
- Risk remaining after controls are applied
- Risk that exists before any controls are in place (Correct answer)
- Risk transferred to a third party
- Risk identified by external auditors
Correct answer: Risk that exists before any controls are in place
Inherent risk is the level of risk present in a process or activity before any mitigating controls are implemented.
Question 3: A hospital compliance officer discovers that the risk assessment has not been updated in three years. What is the MOST significant concern?
- The assessment may not reflect current regulatory requirements and operational changes (Correct answer)
- The document may have formatting inconsistencies
- Staff may be unfamiliar with the original findings
- The assessment cost too much to complete originally
Correct answer: The assessment may not reflect current regulatory requirements and operational changes
Risk assessments must be updated regularly to remain relevant as regulations, operations, and risk landscapes change.
Question 4: Which federal law most directly drives the requirement for healthcare organizations to conduct compliance risk assessments?
- HIPAA Privacy Rule
- False Claims Act (Correct answer)
- HITECH Act
- Stark Law
Correct answer: False Claims Act
The False Claims Act creates substantial liability for fraud and abuse, and the OIG's compliance guidance cites risk assessment as a key mechanism to detect and prevent such violations.
Question 5: When scoping a compliance risk assessment, which approach ensures the HIGHEST coverage of organizational risks?
- Focus only on areas flagged in prior audits
- Limit scope to billing and coding
- Use a universe-based approach covering all business processes (Correct answer)
- Rely solely on department manager self-assessments
Correct answer: Use a universe-based approach covering all business processes
A universe-based approach inventories all business processes and systematically evaluates each for compliance risk, ensuring no area is overlooked.
Question 6: Which of the following BEST describes 'residual risk' in the context of a compliance risk assessment?
- Risk that cannot be identified through standard methods
- Risk that remains after mitigation controls have been applied (Correct answer)
- Risk assigned to a compliance committee
- Risk that is transferred through insurance
Correct answer: Risk that remains after mitigation controls have been applied
Residual risk is what remains after an organization applies controls, and it determines whether additional action is needed.
Question 7: A compliance team at a medical group wants to quantify the financial impact of identified risks. Which method is MOST appropriate?
- Delphi technique
- Monte Carlo simulation (Correct answer)
- Root cause analysis
- Gap analysis
Correct answer: Monte Carlo simulation
Monte Carlo simulation uses probability distributions to model potential financial outcomes across thousands of scenarios, providing quantitative risk estimates.
