CHC Standards, Policies, and Procedures 3

Question 1

Which of the following BEST describes the purpose of a code of conduct in a healthcare compliance program?

Accepted Answer

To articulate the organization's ethical principles and behavioral expectations for all personnel

Answer

A code of conduct communicates the organization's core values and sets behavioral expectations as the ethical foundation of the compliance program.

Question 2

Under the Stark Law, which of the following financial relationships between a physician and a hospital would require a written exception?

Accepted Answer

A physician who owns stock in the hospital and refers Medicare patients there

Answer

Stark Law prohibits physician self-referrals unless a specific exception applies; physician ownership with referrals to that entity requires careful structuring under an applicable exception.

Question 3

A compliance officer discovers that a departmental procedure contradicts a newly updated organization-wide policy. The BEST course of action is to:

Accepted Answer

Escalate to department leadership and legal to align the procedure with the policy

Answer

Conflicting documents create compliance risk; the compliance officer should work with department leadership and legal counsel to reconcile the procedure with the governing policy.

Question 4

The False Claims Act (FCA) imposes liability on healthcare organizations that submit claims that are:

Accepted Answer

Knowingly false or fraudulent to government payers

Answer

The FCA targets knowingly false, fraudulent, or recklessly disregarded claims submitted to federal healthcare programs.

Question 5

Which document type provides the authoritative basis (the 'why') that all related procedures and work instructions should reference?

Accepted Answer

Policy

Answer

A policy establishes the organizational rule or principle that gives authority and rationale to the procedures and work instructions that implement it.

CHC - Certified in Healthcare Compliance Practice Test

CHC - Certified in Healthcare Compliance Practice Test

CHC Standards, Policies, and Procedures 3