RHIA Compliance, Privacy, and Security 2

Question 1

What is the purpose of a healthcare compliance program?

Accepted Answer

Prevent, detect, and correct violations of laws, regulations, and internal policies

Answer

Maximize reimbursement by selecting optimal DRGs

Answer

Manage patient satisfaction scores

Answer

Oversee physician credentialing

Question 2

Under the Anti-Kickback Statute (AKS), which arrangement is prohibited?

Accepted Answer

Offering remuneration to induce referrals of items or services covered by federal health programs

Answer

A hospital employing full-time physicians on salary

Answer

Providing free educational seminars to medical staff

Answer

Participating in a Medicare ACO

Question 3

What is the Stark Law (Physician Self-Referral Law) designed to prevent?

Accepted Answer

Physicians from referring patients to entities in which they have a financial relationship, unless an exception applies

Answer

Physicians from practicing in multiple states

Answer

Hospitals from owning physician practices

Answer

Physicians from accepting gift cards from patients

Question 4

Which federal agency has primary authority to investigate and prosecute healthcare fraud and abuse?

Accepted Answer

The Office of Inspector General (OIG) of HHS

Answer

The Joint Commission

Answer

The American Hospital Association

Answer

CMS directly

Question 5

What is a compliance audit in a health information management context?

Accepted Answer

A systematic review of coded claims and documentation to assess accuracy and regulatory compliance

Answer

An annual financial audit of hospital accounts

Answer

A HIPAA security vulnerability assessment

Answer

A review of patient satisfaction data

Question 6

Under HIPAA, what are the four tiers of civil money penalties for violations?

Accepted Answer

Unknowing violation, reasonable cause, willful neglect corrected, willful neglect not corrected

Answer

Warning, fine, suspension, exclusion

Answer

Minor, moderate, major, critical

Answer

Level 1, Level 2, Level 3, Level 4