CHC Remedial Measures and Discipline 2

Question 1

When a compliance investigation concludes that an employee violated policy unintentionally due to inadequate training, the MOST appropriate remedial measure is:

Accepted Answer

Mandatory retraining and closer supervision

Answer

Immediate termination to deter future violations

Answer

Formal written warning with no follow-up

Answer

Referral to the OIG for voluntary disclosure

Question 2

A compliance officer discovers a physician has been upcoding claims for 18 months. Under the OIG's voluntary disclosure guidance, the organization should:

Accepted Answer

Report to the OIG Self-Disclosure Protocol and cooperate fully

Answer

Quietly refund overpayments without notifying the OIG

Answer

Wait until the False Claims Act statute of limitations expires

Answer

Issue an internal written warning and monitor future claims

Question 3

Which element is MOST critical when documenting disciplinary actions to protect the organization in future legal proceedings?

Accepted Answer

Documenting specific policy provisions violated and evidence supporting the finding

Answer

Recording the supervisor's personal opinion of the employee

Answer

Using informal notes rather than official HR forms

Answer

Omitting dates to preserve employee privacy

Question 4

An organization's corrective action plan submitted to the OIG following a self-disclosure should include all of the following EXCEPT:

Accepted Answer

Names of all patients whose records were reviewed

Answer

Root cause analysis of the violation

Answer

Steps taken to prevent recurrence

Answer

Repayment amount and calculation methodology

Question 5

Under the Federal Sentencing Guidelines, which factor MOST reduces an organization's culpability score after a compliance violation is discovered?

Accepted Answer

Self-reporting the offense to appropriate authorities

Answer

Having a large legal department

Answer

Filing a motion to suppress evidence

Answer

Delaying cooperation until after an audit

Question 6

A compliance hotline report alleges that a manager is retaliating against an employee who raised a billing concern. The compliance officer's FIRST action should be to:

Accepted Answer

Assess whether the allegation warrants a formal investigation before taking any action

Answer

Notify the manager immediately so they can prepare a response

Answer

Terminate the manager pending investigation

Answer

Advise the reporting employee to seek external legal counsel

Question 7

Which disciplinary principle requires that employees in similar roles who commit comparable violations receive comparable sanctions?

Accepted Answer

Consistency

Answer

Progressive discipline

Answer

Proportionality

Answer

Due process