CPHRM Regulatory Compliance 5

Question 1

The Deficit Reduction Act of 2005 requires hospitals receiving more than $5 million annually in Medicaid payments to provide employees with information about:

Accepted Answer

The False Claims Act and whistleblower protections

Answer

The Deficit Reduction Act requires affected entities to educate employees about the federal and applicable state False Claims Acts, whistleblower protections, and the entity's policies for detecting and preventing fraud.

Question 2

Under HIPAA's Breach Notification Rule, a covered entity must notify affected individuals of a breach of unsecured PHI within:

Accepted Answer

60 days of discovery

Answer

The HIPAA Breach Notification Rule requires covered entities to notify affected individuals without unreasonable delay and no later than 60 days following discovery of a breach.

Question 3

A hospital's compliance program must include which element identified in the OIG's seven elements of an effective compliance program?

Accepted Answer

Ongoing monitoring and auditing of compliance risks

Answer

OIG's seven elements include: written standards, compliance officer/committee, training, communication channels, auditing/monitoring, disciplinary guidelines, and response to detected offenses — ongoing auditing and monitoring is one of the seven.

Question 4

A hospital employee reports to the compliance hotline that their supervisor instructed them to alter patient records to avoid a deficiency citation. This situation MOST immediately implicates:

Accepted Answer

CMS Conditions of Participation record integrity requirements and potential obstruction

Answer

Altering medical records to conceal deficiencies violates CMS CoPs record integrity requirements and could constitute obstruction of a federal health care program audit, carrying significant legal consequences.

Question 5

The primary risk management concern with a hospital's non-compete agreements for employed physicians is:

Accepted Answer

Antitrust implications and interference with patient access to care

Answer

Overly broad non-compete agreements for physicians raise antitrust concerns and can impair patient access to care, drawing FTC and state attorney general scrutiny.

CPHRM Exam Practice Test

CPHRM Exam Practice Test

CPHRM Regulatory Compliance 5