COE - Certified Ophthalmic Executive Risk and Regulatory Compliance Questions and Answers

Question 1

An ophthalmology practice performs tear osmolarity testing, which is a CLIA-waived test. To maintain compliance, which of the following is required?

Accepted Answer

Enrolling in the CLIA program by obtaining a Certificate of Waiver.

Answer

Performing proficiency testing twice a year for each technician.

Answer

Appointing a board-certified pathologist as the laboratory director.

Answer

Submitting all test results to the FDA for monthly review.

Question 2

A patient at a high-volume cataract surgery center is unhappy with their premium IOL outcome and is threatening a lawsuit, claiming they were not fully aware of the potential for halos and glare. Which of the following represents the BEST risk management strategy to prevent such claims?

Accepted Answer

Implementing a detailed informed consent process that includes procedure-specific documents reviewed with the patient well before the surgery date.

Answer

Having the surgeon verbally mention all risks during the pre-operative consultation.

Answer

Providing a standard, pre-printed consent form for the patient to sign on the day of surgery.

Answer

Offering a satisfaction guarantee and a partial refund to all dissatisfied patients.

Question 3

To comply with the HIPAA Security Rule, an ophthalmic practice administrator must ensure the implementation of administrative, technical, and physical safeguards. Which of the following is an example of a required ADMINISTRATIVE safeguard?

Accepted Answer

Conducting a formal, documented Security Risk Analysis (SRA).

Answer

Installing and maintaining antivirus software on all computers.

Answer

Placing workstation monitors so they are not visible to people in the waiting room.

Answer

Using encrypted email for all communications containing PHI.

Question 4

An ophthalmology practice's new marketing director proposes a program where local optometrists receive $100 for every patient they refer who undergoes cataract surgery at the practice. Which regulation would this arrangement most directly violate?

Accepted Answer

The Anti-Kickback Statute (AKS)

Answer

The Health Insurance Portability and Accountability Act (HIPAA)

Answer

The Clinical Laboratory Improvement Amendments (CLIA)

Answer

The Occupational Safety and Health Act (OSHA)

Question 5

During an internal audit, it is discovered that the billing department has been unbundling procedures and billing for a comprehensive eye exam and a fundus photograph separately for every new diabetic patient, even when not medically necessary, to increase reimbursement. This practice puts the clinic at high risk of an audit and penalties from which government agency?

Accepted Answer

The Office of Inspector General (OIG)

Answer

The Drug Enforcement Administration (DEA)

Answer

The Federal Trade Commission (FTC)

Answer

The Centers for Disease Control and Prevention (CDC)

Question 6

Which of the following is a key requirement of the OSHA Hazard Communication Standard for an ophthalmic practice?

Accepted Answer

Maintaining accessible Safety Data Sheets (SDS) for all hazardous chemicals.

Answer

Providing Hepatitis B vaccinations to all clinical staff.

Answer

Documenting all needlestick injuries in a specific sharps injury log.

Answer

Ensuring all staff complete BLS certification annually.