New Hire Orientation: Compliance Training Test! Trivia Quiz

The Anti-Kickback Statute is a legal provision that prohibits healthcare providers from soliciting referrals of Medicare or Medicaid patients, as well as paying or receiving payment for such referrals. It also prohibits offering discounts or other inducements to encourage the purchase of items or services covered by Medicare or Medicaid. This statute aims to prevent fraud and abuse in the healthcare system by ensuring that patient referrals are based on medical necessity rather than financial incentives.

HIPAA stands for the Health Insurance Portability and Accountability Act. It is a set of national standards that regulate the health care industry and the exchange of health care information. HIPAA applies to health plans, health care clearinghouses, and health care providers who perform electronic transactions. It ensures the privacy and security of patient health information and establishes guidelines for the electronic transmission of health data.

The correct answer is "Business arrangements between those in a position to refer business and those providing services." This is because the Anti-Kickback Statute refers to laws that prohibit offering, paying, soliciting, or receiving anything of value in exchange for referrals or business in healthcare settings. It is designed to prevent improper financial relationships that could influence medical decision-making and lead to fraud or abuse.

The correct answer is "Easy access to information transmitted electronically without concerns for security or privacy of patient information." This option is not one of the "Seven Components of a Compliance Program." The seven components include written standards of conduct, written policies and procedures, education and training programs for all employees yearly, monitoring and auditing for risk areas, enforcing standards through well-publicized disciplinary guidelines, responding promptly to detected offenses, and developing corrective action.

The correct answer is "Using a billing code that provides a higher reimbursement rate than the services actually performed." This refers to the practice of intentionally using a billing code that results in a higher payment from insurance or other reimbursement sources, even if the services provided do not warrant that level of payment. This can be considered fraudulent and is a compliance risk area.

The correct answer is "A process to identify, correct and prevent improper conduct or errors in the course of normal business" and "Promotes Ethical Behavior for all operations" because both options describe the key elements of a compliance program. A compliance program is designed to identify and address any improper conduct or errors that may occur in the course of normal business operations. It also aims to promote ethical behavior throughout the organization to ensure compliance with laws, regulations, and ethical standards.

Compliance with government legislation is a collective responsibility that falls on everyone at MBS, including the individual answering the question. This means that every employee, including the person taking the quiz, has a role in ensuring that MBS adheres to government regulations. It emphasizes the importance of a shared commitment to compliance throughout the organization.

Password should never be shared.

The False Claims Act is a law that prohibits knowingly filing a false claim for payment or conspiring to defraud the government by getting a fraudulent claim allowed or paid. This law is considered the government's primary enforcement tool for fraud. It is designed to hold individuals and organizations accountable for submitting false claims and seeking reimbursement from the government for services or products that were not provided or were misrepresented. The False Claims Act aims to protect taxpayer dollars and ensure the integrity of government programs and services.

The term "unbundling" refers to the practice of using separate billing codes for procedures that should be billed together under one aggregate billing code. This practice is considered non-compliant as it can lead to higher reimbursement rates than the services actually performed.

The correct answer is "Used to indicate procedure performed has been altered by specific circumstances." This means that the compliance "Risk area" being referred to is when a procedure has been modified or changed due to specific circumstances. It could be that the procedure was altered to accommodate a patient's unique needs or to address unexpected complications during the procedure. This is important to track and document accurately for billing and compliance purposes.

When faced with a compliance concern, it is important to address it appropriately. Talking through your concerns with your immediate supervisor or group director is crucial as they are responsible for handling such issues within the organization. It allows for open communication and provides an opportunity to resolve the concern internally. Additionally, filling out a Compliance Incident Report Form is necessary to document the concern and ensure it is properly investigated and addressed by the appropriate authorities.

Making fraudulent offers of products, items or services is not an acceptable use of MBS computers because it is illegal and unethical. It goes against the principles of honesty and integrity, and it can lead to legal consequences for the individual and damage to the reputation of MBS. Acceptable uses of MBS computers include supporting the business, helping users with their work, and ensuring the security and privacy of sensitive information. Downloading files from the Internet using the provided anti-virus software and keeping Protected Health Information hidden from unauthorized persons are also acceptable uses as they contribute to the efficient functioning and security of the organization.

Selling or sharing patients' Medicare numbers is an example of fraud because it involves the intentional and unauthorized disclosure of confidential information for personal gain. Knowingly and deliberately billing for services not rendered is also an example of fraud as it involves submitting false claims for services that were not actually provided, with the intent to deceive and receive payment fraudulently.

The IT department is responsible for the software on MBS computers and laptops. They are in charge of installing, updating, and maintaining the software to ensure that it runs smoothly and meets the needs of the organization. This department is knowledgeable about various software applications and can provide technical support when needed. They play a crucial role in managing the technology infrastructure of the company and ensuring that all software is up to date and secure.

The U.S. Department of Health and Human Services (DHHS), Office of the Inspector General (OIG) has authority over Medicare and Medicaid programs, coordinates investigations with other federal and state law enforcement agencies, and issues compliance program guidance for various sectors of the healthcare industry. This means that the OIG is responsible for ensuring the integrity and proper functioning of these healthcare programs, investigating any potential fraud or abuse, and providing guidance to promote compliance with regulations in the healthcare industry.

The MBS management's policy regarding non-retaliation encourages employees to report compliance issues without fear of retaliation. Additionally, the management will handle the reported issues with discretion and integrity. Furthermore, they will make efforts to maintain the confidentiality of the employee's identity.

The correct answer is Peggy McCloskey. Peggy McCloskey is the Chief Compliance Officer.

HIPAA (Health Insurance Portability and Accountability Act) provides new protections for the collection, handling, storage, and transmission of protected health information. It also protects the storage and transmission of patients' information, such as addresses and Social Security numbers. By implementing these protections, HIPAA ensures the privacy and security of individuals' health information, reducing the risk of unauthorized access or disclosure. This helps to build trust between patients and healthcare providers, as well as facilitate the secure exchange of electronic health data, ultimately improving the overall quality of healthcare delivery.