Corporate Compliance: A Proactive Stance (2019)

What is the penalty for violating the Federal False Claims Act?

A fine equal to three times the billed amount. A provider who violates the Federal False Claim Act may be fined triple damages for the billed amount.

What is one result of an effective corporate compliance program in a healthcare facility?

A more efficient use of taxpayer money. An effective compliance program helps a healthcare facility minimize financial loss to the government and taxpayers.

The whistleblower provision of the Federal False Claims Act:

All of the above. All of these are provided for in the whistleblower provision of the Federal False Claims Act.

A hospital offers a gift to physicians in exchange for their referrals of Medicare patients. This would be a violation of the:

Anti-Kick Back Statute. Offering gifts for referrals would be a violation of the anti-kickback statue.

Which of the following is a key law for regulating the healthcare industry?

EMTALA, or the patient anti-dumping statute, makes it illegal for hospitals to refuse emergency care on the basis of ability to pay.

What is the focus of the Stark Act?

Ethics in patient referrals. The Start Act makes it illegal for a provider to refer patients to a provider or facility with whom the referring provider has a financial relationship.

What is a possible penalty for violating the AKBS?

Exclusion from Medicare and Medicaid. Providers who violate the AKBS may be excluded from Medicare and Medicaid.

An intentional representation that could result in an unauthorized benefit is considered:

Fraud. Fraud involves intention. Abuse is not intentional.

Which of the following is a key law for regulating the healthcare industry?

HIPAA Privacy Rule. The HIPAA Privacy Rule restricts the disclosure of protected health information (PHI).

What is one result of an effective corporate compliance program in a healthcare facility?

Help keep healthcare costs low. Because a compliance program helps prevent fraud, abuse, and waste, an effective program helps keep healthcare costs low.

What is the focus of the Red Flags Rule?

Identity theft. The Red Flags Rule, which is part of the Fair and Accurate Credit Transactions Act, helps protect individuals from identity theft.

Which of the following is one component of an effective compliance program?

Internal auditing and monitoring. An effective compliance program includes internal auditing and monitoring.

Why are open lines of communication important to an effective compliance program?

Open communication increases the ability to identify problems early and correct problems promptly. Open communication increases the ability to identify problems early and correct problems promptly.

Which of the following is one component of an effective compliance program?

Policies and procedures. An effective compliance program includes compliance policies and procedures.

What is the purpose of a corporate compliance program?

To help prevent fraud and misconduct. To help prevent misconduct, healthcare facilities have corporate compliance programs.

Why do healthcare facilities have corporate compliance programs?

To help prevent fraud, abuse, and waste. A good corporate compliance program helps to prevent fraud, abuse, and waste.

What is the purpose of compliance policies and procedures?

To provide employees with guidance about how to do their jobs legally and ethically. Compliance policies and procedures provide rules to help employees do their jobs legally and ethically.