Trivium Quality Improvement and Compliance 3

Question 1

Under the False Claims Act, whistleblowers who report Medicare/Medicaid fraud may receive:

Accepted Answer

A percentage of the government's recovery as a reward

Answer

The False Claims Act's qui tam provisions allow whistleblowers to receive 15–30% of the government's recovery in successful fraud cases.

Question 2

A healthcare organization's compliance program should include which of the following elements?

Accepted Answer

Written policies, training, auditing, and a reporting mechanism

Answer

An effective compliance program includes written standards, training, auditing/monitoring, and mechanisms for employees to report concerns.

Question 3

Which statistical tool is commonly used in quality improvement to display variation in a process over time?

Accepted Answer

Control chart (run chart)

Answer

Control charts (also called run charts or Shewhart charts) plot data over time to distinguish normal process variation from special cause variation.

Question 4

A patient's protected health information (PHI) can be disclosed WITHOUT patient authorization for which purpose?

Accepted Answer

Treatment, payment, and healthcare operations (TPO)

Answer

HIPAA permits disclosure of PHI without authorization for treatment, payment, and healthcare operations (TPO) activities.

Question 5

A fishbone (Ishikawa) diagram is used in quality improvement to:

Accepted Answer

Identify and categorize potential causes of a problem

Answer

A fishbone diagram visually maps cause-and-effect relationships to identify all potential root causes of a quality problem.

(Trivium) Trivium Health Care Exam Practice Test