CHC Remedial Measures and Discipline 4

Question 1

A compliance officer is reviewing a case where a nurse submitted false time records. The investigation is complete and discipline is warranted. Which sequence reflects BEST practice?

Accepted Answer

Investigate thoroughly, document findings, consult HR and legal, then impose proportional discipline

Answer

Best practice requires completing a thorough investigation and consulting HR and legal before imposing discipline to ensure fairness, accuracy, and legal defensibility.

Question 2

Which of the following is an example of a SYSTEMIC remedial measure rather than an individual disciplinary measure?

Accepted Answer

Revising the billing policy and retraining the entire coding department

Answer

Systemic remedial measures address organizational processes and controls, whereas individual disciplinary measures target the specific wrongdoer.

Question 3

An IRO (Independent Review Organization) engaged under a CIA is PRIMARILY responsible for:

Accepted Answer

Conducting independent reviews of claims and operations to verify compliance program effectiveness

Answer

An IRO conducts objective, independent reviews as required by the CIA to provide the OIG with assurance that the organization's compliance program is functioning effectively.

Question 4

A compliance investigation finds that a vendor, not an employee, caused the billing error. The MOST appropriate remedial step is to:

Accepted Answer

Review and strengthen vendor contracts, oversight procedures, and potentially terminate the vendor relationship

Answer

When a vendor causes compliance failures, the organization must address its own oversight controls and the vendor relationship to prevent recurrence.

Question 5

Under the OIG's compliance program guidance, effective discipline programs must be applied to:

Accepted Answer

All levels of the organization, including senior management and executives

Answer

The OIG emphasizes that compliance programs lose credibility if discipline is not applied consistently at all organizational levels, including leadership.

CHC - Certified in Healthcare Compliance Practice Test

CHC - Certified in Healthcare Compliance Practice Test

CHC Remedial Measures and Discipline 4