CHC Healthcare Compliance Laws 4

Question 1

Under a Corporate Integrity Agreement (CIA), which reporting obligation is typically imposed on a healthcare organization?

Accepted Answer

Annual reports to the OIG documenting compliance program activities

Answer

CIAs typically require covered entities to submit annual reports to the OIG documenting their compliance program activities, claims audits, training completion, and any reportable events discovered during the year.

Question 2

The AKS safe harbor for personal services and management contracts requires that compensation be set in advance and be consistent with what standard?

Accepted Answer

Fair market value and not determined based on referral volume

Answer

Under the personal services safe harbor, aggregate compensation must be set in advance, be consistent with fair market value, and must not be determined in a manner that accounts for the volume or value of referrals.

Question 3

Which Affordable Care Act provision created the first federal requirement to screen and re-screen providers and suppliers before enrolling them in Medicare and Medicaid?

Accepted Answer

Section 6401 — Provider Screening and Other Enrollment Requirements

Answer

ACA Section 6401 established categorical screening levels (limited, moderate, high) and mandated that CMS and states screen all providers and suppliers upon enrollment and periodically thereafter.

Question 4

A physician receives free tickets to a sporting event from a medical device company. Under the AKS, the primary risk is that these tickets may constitute what?

Accepted Answer

Remuneration intended to induce referrals or purchases

Answer

Providing gifts of value to physicians can constitute remuneration under the AKS if given with the intent to induce or reward referrals of items or services reimbursable by federal healthcare programs.

Question 5

Under the HIPAA Breach Notification Rule, when must a covered entity notify HHS of a breach affecting fewer than 500 individuals?

Accepted Answer

No later than 60 days after the end of the calendar year in which the breach occurred

Answer

For breaches affecting fewer than 500 individuals, covered entities must notify HHS no later than 60 days after the end of the calendar year in which the breach occurred, via the HHS online log.

CHC - Certified in Healthcare Compliance Practice Test

CHC - Certified in Healthcare Compliance Practice Test

CHC Healthcare Compliance Laws 4