CHC Regulatory Compliance and Government Oversight Questions and Answers

Question 1

Which federal agency publishes the OIG Work Plan that healthcare compliance officers use to prioritize audit areas each year?

Accepted Answer

Office of Inspector General (OIG)

Answer

The OIG publishes its annual Work Plan to identify areas of focus for audits and investigations in Medicare and Medicaid programs.

Question 2

What is the primary purpose of the OIG's List of Excluded Individuals and Entities (LEIE)?

Accepted Answer

To identify parties excluded from participating in federal healthcare programs

Answer

The LEIE identifies individuals and entities excluded from participation in Medicare, Medicaid, and other federal healthcare programs due to fraud, abuse, or other disqualifying conduct.

Question 3

A Corporate Integrity Agreement (CIA) is typically entered into between a healthcare entity and which agency?

Accepted Answer

OIG

Answer

CIAs are negotiated between the OIG and healthcare providers as a condition of settling False Claims Act cases, requiring ongoing compliance obligations.

Question 4

Under the Stark Law (42 U.S.C. § 1395nn), which of the following best describes a 'designated health service'?

Accepted Answer

Specific services including clinical laboratory and physical therapy that trigger the self-referral prohibition

Answer

Stark Law designates specific health services such as clinical laboratory, physical therapy, radiology, and others where physician self-referral to entities with a financial relationship is prohibited.

Question 5

Which statute imposes criminal and civil penalties for knowingly submitting false claims to federal healthcare programs?

Accepted Answer

False Claims Act

Answer

The False Claims Act (31 U.S.C. §§ 3729–3733) imposes liability on persons who knowingly present false or fraudulent claims for payment to the federal government.

CHC - Certified in Healthcare Compliance Practice Test

CHC - Certified in Healthcare Compliance Practice Test

CHC Regulatory Compliance and Government Oversight Questions and Answers