Compliance 101 : Trivia Test Questions! Quiz

1.

The OIG performs all of the following EXCEPT:

A.

A. Issues guidance to health care organizations on compliance programs.
B.

B. Administers the Medicare and Medicaid programs.
C.

C. Conducts audits of health care organizations’ billing practices.
D.

D. Investigates suspected health care fraud and abuse.

Correct Answer
B. B. Administers the Medicare and Medicaid programs.

Explanation
COMMENT: The OIG is an oversight organization that conducts audits and investigations of health care billing practices. It does not administer any programs.

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2.

An effective compliance program should:

A.

A. Reaffirm key organizational principles, such as quality and superior service.
B.

B. Be consistent with the organization’s culture.
C.

C. Permeate the organization, so that all employees are aware of their role in compliance and their duty to raise compliance-related concerns.
D.

D. All of the above.

Correct Answer
D. D. All of the above.

Explanation
COMMENT: As explained in OIG compliance guidances, to be effective a compliance program reaffirms the organization’s major principles, is consistent with the organization’s mission and culture, meets the U. S. Sentencing Commission Guidelines, and is well publicized throughout the organization so that all employees understand their responsibilities with respect to compliance.

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3.

How many elements do the U.S. Sentencing Commission and the HHS OIG identify as comprising an “effective” compliance program?

A.

Six
B.

Ten
C.

Seven
D.

Five

Correct Answer
C. Seven

Explanation
COMMENT: Both organizations specify seven elements that are necessary for a compliance program to be effective: (1) high level oversight and infrastructure, (2) written compliance guidance, (3) compliance education and training, (4) open lines of communication, (5) screening and enforcement, (6) auditing and monitoring of regulatory compliance issues, and (7) investigation and resolution of potential compliance issues.

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4.

Which of the following would be part of an organization’s high level oversight and infrastructure for compliance?

A.

A. Board Compliance Committee
B.

B. Senior level Compliance Officer
C.

C. Executive Compliance Committee
D.

D. All of the above

Correct Answer
D. D. All of the above

Explanation
COMMENT: The Board should appoint a Compliance Committee to provide ongoing oversight of the compliance program, and compliance issues and updates should be discussed by the full board at every board meeting. The Compliance Officer should be a senior level official who reports directly to the CEO and the Board. The Compliance Officer should report to the Board Compliance Committee prior to board meetings and also attend regular Board meetings. The OIG recommends against making compliance part of the organization’s legal or finance functions. The Executive Compliance Committee, comprised of senior officials within the organization, advises and assists the Compliance Officer in compliance program implementation.

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5.

Is the following statement true or false? Directors and officers can be held personally liable if they breach their “duty of care” to the organization.

A.

True
B.

False

Correct Answer
A. True

Explanation
The Caremark Decision (1992) held that Directors and officers can be held personally liable if they knew or should have known that violations of the law were occurring and took no steps in good faith to prevent or remedy the situation.

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6.

A compliance hotline allows employees to raise compliance issues and concerns. Which of the following would NOT be appropriate for managing the hotline?

A.

A. Employees may remain anonymous.
B.

B. No retaliation for reporting.
C.

C. Employee is asked to provide name and contact information when reporting a issue.
D.

D. Promise of confidentiality if employee identifies herself/himself.
E.

E. Prompt investigation of issue.

Correct Answer
C. C. Employee is asked to provide name and contact information when reporting a issue.

Explanation
COMMENT: The hotline never asks an employee to give name or other identifying information, and if the employee voluntarily provides this information, it must be kept confidential. Employees are guaranteed the right to report concerns anonymously and there must be a strict promise or No Retaliation. Such information should be posted prominently in areas where employees congregate (e.g., next the elevator, in the cafeteria) and emphasized in compliance education.

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7.

Which of the following would be appropriate oversight activities for Health Care Boards?

A.

A. Use numerical indicators – sometimes called dashboards – to gauge the quality of patient care.
B.

B. Ask questions to satisfy themselves that the organization’s executives are making appropriate decisions.
C.

C. Serve as responsible stewards of the organization’s resources.
D.

D. All of the above

Correct Answer
D. D. All of the above

Explanation
COMMENT: In recent years the OIG has stressed Board responsibility with respect to quality of patient care, recommending the use of dashboards to gauge quality of care. The OIG has issued several resource documents to help Boards formulate appropriate questions to ask to help determine whether the organization’s executives are making decisions that support the organization’s mission, promote quality of care, and comply with applicable laws and regulations.

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