Compliance and Regulatory Training Flashcards
7 cards from real RELIAS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Compliance and Regulatory Training flashcards as text
When conducting a HIPAA Security Risk Analysis, a covered entity must evaluate:
Answer: All electronic protected health information (ePHI) created, received, maintained, or transmitted
The Security Risk Analysis must cover all ePHI across all systems and media, including creation, receipt, maintenance, and transmission.
Which of the following scenarios represents a conflict of interest in a healthcare compliance context?
Answer: A compliance officer who owns stock in a vendor whose contract she approves
A compliance officer with a financial stake in a vendor she oversees has a direct conflict of interest that compromises her objectivity and independence.
Under the No Surprises Act, patients receiving emergency care out-of-network are protected from balance billing for:
Answer: Emergency services and certain non-emergency services at in-network facilities without prior consent
The No Surprises Act limits balance billing for out-of-network emergency care and for certain non-emergency services at in-network facilities when patients lack meaningful choice.
What is the primary goal of conducting a compliance program effectiveness review?
Answer: Assessing whether compliance efforts are actually preventing and detecting violations
Effectiveness reviews evaluate whether the compliance program's elements are functioning as intended to prevent, detect, and correct non-compliance.
Which of the following is a key principle of the Federal Sentencing Guidelines related to organizational compliance?
Answer: Having an effective compliance program can reduce culpability scores and potential fines
The Federal Sentencing Guidelines allow organizations with effective compliance programs to receive reduced culpability scores, potentially lowering fines significantly.
An employee is terminated after reporting a compliance concern. Under federal law, this termination may violate:
Answer: Whistleblower protection provisions under the False Claims Act and other statutes
The False Claims Act and other federal statutes prohibit retaliation against employees who report suspected fraud or compliance violations in good faith.
In a healthcare compliance audit, 'extrapolation' refers to:
Answer: Using a statistical sample of claims to calculate overpayment across the entire claims universe
Extrapolation applies the error rate found in a statistical sample to the total population of claims to estimate the full overpayment amount.