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

A healthcare compliance program establishes policies, training, and monitoring mechanisms to prevent, detect, and correct legal and regulatory violations.

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

The AKS prohibits knowingly offering, paying, soliciting, or receiving remuneration to induce or reward referrals of items or services reimbursable by federal healthcare programs.

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

The Stark Law prohibits physicians from referring Medicare/Medicaid patients to entities with which the physician or immediate family member has a financial relationship, unless a specific exception applies.

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 OIG of HHS has primary authority to investigate healthcare fraud, issue exclusions from federal programs, and impose civil monetary penalties on violators.

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

A compliance audit in HIM systematically reviews coded claims and supporting documentation to identify errors, inconsistencies, and potential regulatory violations.

RHIA Exam Practice Test

RHIA Exam Practice Test

RHIA Compliance, Privacy, and Security 2