The first step in handling a compliance complaint is to assess the nature of the complaint and determine whether it involves a potential violation of laws, regulations, or internal policies. Reporting to OCR (A) is premature unless a breach or violation has been confirmed. Disciplinary action (D) can only occur after investigation.
A critical best practice in compliance investigations is thorough documentation of every step, finding, and conclusion. This ensures transparency and accountability. Confidentiality must be preserved, but interviewing only one party (A) would limit a fair investigation.
Under HIPAA, the healthcare provider must investigate the complaint to determine if an unauthorized access or breach occurred. Immediate disciplinary action (A) without investigation is premature. Reporting to the media (C) is only required if a confirmed breach affects more than 500 individuals.
The primary purpose of interviewing witnesses during an internal investigation is to gather evidence to substantiate or disprove allegations. The investigation must be fair, objective, and fact-driven. Identifying feelings about the compliance program (C) is unrelated to the investigation process.
Please select 3 correct answers
When a significant compliance violation is identified:
Corrective actions (A) must be implemented to address the root cause.
If required, report the violation to regulatory authorities (B), such as the OCR or CMS.
Conduct staff retraining (C) to prevent recurrence and reinforce compliance standards.
Proper documentation of the investigation must be maintained (D); it cannot be erased for confidentiality.
