CHC Healthcare Compliance Laws 3

Question 1

Under the Exclusion Statute, which OIG exclusion type is mandatory and has no discretion for waiver?

Accepted Answer

Exclusion following conviction of program-related crimes

Answer

Mandatory exclusions under 42 U.S.C. § 1320a-7(a) are triggered by convictions for program-related crimes, patient abuse, felony healthcare fraud, and controlled substance felonies — the OIG has no discretion to waive these.

Question 2

The HITECH Act extended HIPAA obligations directly to which class of entities that were not previously directly regulated?

Accepted Answer

Business associates

Answer

HITECH made business associates directly subject to HIPAA's Security Rule and many Privacy Rule provisions, and created direct liability for breaches caused by business associates.

Question 3

A hospital discovers a billing error that resulted in overpayments from Medicare over the past 18 months. Under the 60-day rule, when must repayment be initiated?

Accepted Answer

Within 60 days of identification and quantification of the overpayment

Answer

The 60-day rule (ACA Section 6402) requires that identified overpayments be reported and returned within 60 days of the date the overpayment is identified, or the date any corresponding cost report is due, whichever is later.

Question 4

Under the Deficit Reduction Act of 2005, which entities are required to establish written policies educating employees about the False Claims Act?

Accepted Answer

Entities receiving $5 million or more annually in Medicaid payments

Answer

The Deficit Reduction Act requires entities receiving $5 million or more in annual Medicaid payments to establish written policies informing employees about the FCA and the entity's policies for detecting fraud and abuse.

Question 5

Which standard governs how healthcare organizations must safeguard electronic protected health information (ePHI) under federal law?

Accepted Answer

HIPAA Security Rule

Answer

The HIPAA Security Rule establishes national standards for protecting ePHI through administrative, physical, and technical safeguards.

CHC - Certified in Healthcare Compliance Practice Test

CHC - Certified in Healthcare Compliance Practice Test

CHC Healthcare Compliance Laws 3