General Surgery Board Review Regulatory Frameworks & Compliance 4

Question 1

A surgeon performs a 'never event' — a wrong-site surgery. Under current CMS policy, this event is:

Accepted Answer

Non-reimbursable; CMS will not pay for care related to the preventable error

Answer

CMS designates certain serious reportable events (formerly 'never events') as non-reimbursable; hospitals cannot bill Medicare or Medicaid for care resulting from wrong-site surgery.

Question 2

The Joint Commission's Universal Protocol is designed to prevent wrong-site, wrong-procedure, and wrong-patient surgeries. The three core components are:

Accepted Answer

Pre-procedure verification, site marking, and a time-out

Answer

The Joint Commission Universal Protocol requires a pre-procedure verification process, marking of the operative site, and a time-out immediately before the procedure starts.

Question 3

Under OSHA's Bloodborne Pathogens Standard, surgical employers must offer hepatitis B vaccination to employees with occupational exposure:

Accepted Answer

At no cost to the employee, within 10 working days of initial assignment

Answer

OSHA's Bloodborne Pathogens Standard (29 CFR 1910.1030) mandates that employers provide hepatitis B vaccination free of charge within 10 working days of initial assignment to occupational exposure.

Question 4

The Health Care Quality Improvement Act (HCQIA) provides peer review immunity to hospitals when conducting professional review actions, provided the action is taken:

Accepted Answer

In the reasonable belief it furthers quality health care, with adequate notice and hearing procedures

Answer

HCQIA grants immunity for professional review actions that meet four criteria: reasonable belief the action furthers quality care, reasonable effort to obtain facts, adequate notice and hearing, and reasonable belief the action was warranted.

Question 5

A hospital's compliance officer discovers upcoding on surgical claims submitted over three years. Under the False Claims Act, the statute of limitations for the government to bring a civil action is generally:

Accepted Answer

Six years from the violation, or three years from when the government knew or should have known, whichever is later (up to 10 years)

Answer

The FCA's statute of limitations is the later of 6 years from the violation or 3 years after the government learns of it, but no more than 10 years total.

General Surgery Board Review Practice Test

General Surgery Board Review Practice Test

General Surgery Board Review Regulatory Frameworks & Compliance 4