HMCC Healthcare Compliance Fundamentals 2

Question 1

What is the False Claims Act and how does it apply to healthcare?

Accepted Answer

A federal law imposing liability on persons who defraud governmental programs, including submitting false claims for healthcare reimbursement

Answer

A law about false advertising of medications

Answer

A regulation about medical device labeling

Answer

A rule about patient consent forms

Question 2

What is a qui tam provision?

Accepted Answer

A provision in the False Claims Act allowing private citizens (whistleblowers) to file lawsuits on behalf of the government and share in recovered funds

Answer

A medical billing code

Answer

A type of patient consent

Answer

A healthcare facility license

Question 3

What is the Sunshine Act (Open Payments Program)?

Accepted Answer

A federal law requiring pharmaceutical and medical device companies to report payments and transfers of value to physicians and teaching hospitals

Answer

A law about hospital lighting requirements

Answer

A regulation about solar energy in healthcare facilities

Answer

A rule about transparency in hospital pricing

Question 4

What is a Corporate Integrity Agreement (CIA)?

Accepted Answer

A binding agreement between OIG and a healthcare entity resolving fraud allegations, requiring specific compliance measures for a set period

Answer

A business partnership contract

Answer

An agreement between hospitals to share resources

Answer

A patient bill of rights document

Question 5

What is EMTALA and what does it require?

Accepted Answer

The Emergency Medical Treatment and Labor Act requiring hospitals with emergency departments to provide screening examinations and stabilizing treatment regardless of ability to pay

Answer

A law about medical laboratory accreditation

Answer

A regulation about telemedicine licensing

Answer

A rule about hospital construction

Question 6

What are the penalties for HIPAA violations?

Accepted Answer

Civil penalties ranging from $100 to $50,000+ per violation (capped at $1.5M per year), plus potential criminal penalties including imprisonment

Answer

A verbal warning only

Answer

No penalties exist for HIPAA violations

Answer

Only the covered entity is penalized, never individuals