Ethics and Regulatory Compliance
Ethics and Regulatory Compliance Quiz
Test your knowledge on ethics and regulatory compliance with our comprehensive quiz designed for professionals in the healthcare field. Engage with challenging questions that cover key topics such as compliance investigations, Medicare rules, and effective practices for ensuring adherence to regulations.
- Understand the role of various compliance institutions.
- Learn about the implications of the Medicare 60-Day Rule.
- Discover how to respond effectively to compliance inquiries.
What are two (2) institutions that investigate compliance?
Office of the Inspector General
Medicare
Department of Justice
American Medical Association
If an investigator shows up, what do you do? Check all that apply.
Answer their questions
Tell them your outside counsel will contact them
Call your boss
Refuse to answer questions without counsel present
What is a Reverse False Claim?
The money is paid back
Unbundling
Keeping money inappropriately paid
Claim made for work that was not performed
How can you ensure compliance? Check all that apply.
Internal audits
Reviewing and updating compliance policies
Have a compliance officer
Make sure all employees read compliance policies and procedures
Which direction are enforcement trends heading?
Whistleblowers
Medicare audit compliance
60-Day Rule
Criminal rather than civil prosecution
Who do Medicare fraud units coordinate with? Check all that apply
State Medicaid Fraud Control
Office of Civil Rights
Department of Justice
Office of the Inspector General
What should you do if you are under investigation? Check all that apply.
An internal investigation
Personnel interviews
Third party audit
All of the above
Compliance policies and procedures are in place. What else is needed? Check all that apply.
Risk-based training
Confidential reporting mechanism
Effective training of all employees
All of the above
What is the Medicare 60-Day Rule?
Once an overpayment has been identified, you have 60 days to make arrangements to pay it back
You have 60 days to repay an overpayment
If you know, or should have known, that an overpayment was made, repayment needs to be within 60 days
You have 60 days to make a Medicare payment
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