CHC Compliance Risk Assessments 3

Question 1

Under OIG compliance program guidance, how frequently should a healthcare organization's compliance risk assessment be reviewed?

Accepted Answer

At least annually or when significant changes occur

Answer

The OIG recommends that risk assessments be conducted at least annually and revisited whenever significant organizational or regulatory changes occur.

Question 2

Which stakeholder group's input is MOST critical to include during a compliance risk assessment interview phase?

Accepted Answer

Front-line staff who perform day-to-day operations

Answer

Front-line staff have direct knowledge of operational vulnerabilities and process breakdowns that may not be visible to leadership.

Question 3

A compliance officer is rating risks on a 1-5 scale for both likelihood and impact. What does this technique produce?

Accepted Answer

A risk score used to rank and prioritize risks

Answer

Multiplying likelihood and impact scores produces a composite risk score that allows the compliance team to rank and prioritize mitigation efforts.

Question 4

A healthcare system is expanding into a new state with different Medicaid billing rules. How should the compliance team respond?

Accepted Answer

Conduct a targeted risk assessment specific to the new state requirements

Answer

Geographic or service-line expansions trigger the need for a targeted risk assessment to identify jurisdiction-specific compliance exposures.

Question 5

What is the PRIMARY purpose of benchmarking against OIG Work Plans during a compliance risk assessment?

Accepted Answer

To identify areas regulators are actively scrutinizing for potential fraud and abuse

Answer

The OIG Work Plan highlights audit and enforcement priorities, helping organizations proactively focus their risk assessments on areas of heightened regulatory interest.

CHC - Certified in Healthcare Compliance Practice Test

CHC - Certified in Healthcare Compliance Practice Test

CHC Compliance Risk Assessments 3