CHC Standards, Policies, and Procedures 5

Question 1

Which of the following is an example of a compliance 'standard' as distinct from a 'policy' or 'procedure'?

Accepted Answer

The requirement that all PHI transmissions be encrypted to NIST standards

Answer

A step-by-step checklist for submitting a Medicare claim

Answer

A memo announcing the new compliance officer's appointment

Answer

A training schedule for annual compliance education

Question 2

When a compliance policy conflicts with a state law that is MORE restrictive than federal law, the organization must:

Accepted Answer

Follow the more restrictive state law unless federal law explicitly preempts it

Answer

Follow federal law exclusively, as it preempts all state law

Answer

Petition the OIG for a waiver before implementing either standard

Answer

Apply whichever standard is less burdensome to operations

Question 3

A compliance risk assessment should inform policy development by:

Accepted Answer

Identifying high-risk areas where robust policy controls are most needed

Answer

Replacing the need for written policies in low-risk areas

Answer

Delegating all policy writing to external consultants

Answer

Limiting policies to areas where violations have already occurred

Question 4

Under the FCA's qui tam provisions, a relator (whistleblower) who files a successful lawsuit on behalf of the government may receive:

Accepted Answer

15–30% of the government's recovery in the case

Answer

Immunity from all future compliance audits

Answer

A guaranteed permanent employment position at the defendant organization

Answer

Reimbursement of only their documented legal fees

Question 5

A healthcare organization's policy version control system should MOST importantly track:

Accepted Answer

Effective dates, revision history, approving authority, and next review date

Answer

The word count of each policy revision

Answer

The number of employees who accessed each policy version

Answer

The department that requested the policy change

Question 6

Which of the following is the PRIMARY purpose of a healthcare organization's document retention policy?

Accepted Answer

To ensure records are retained for legally required periods and disposed of securely

Answer

To minimize the volume of paper stored in physical filing rooms

Answer

To prevent employees from accessing historical compliance documents

Answer

To standardize font sizes and formatting across all organizational documents

Question 7

A compliance officer is updating a policy on medical necessity documentation. Which external source should be consulted FIRST to ensure regulatory alignment?

Accepted Answer

CMS Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs)

Answer

The organization's marketing department guidance

Answer

Peer-reviewed clinical journals on treatment efficacy

Answer

The state medical board's physician licensure standards