Which of the following is true about compliance programs?
D) An effective compliance program begins by educating staff on proper coding, billing and other risks
Which of the following is (are) true about criminal law and penalties?
D)Standard is a knowing action or reckless disregard of the law
Which of the following is (are) true about civil law and penalties?
D)All the above are true
Which agency leads civil enforcement for Medicare and Medicaid?
B) OIG
Which of the following is (are) a reason for mandatory exclusion of a provider from Medicare and Medicaid?
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B) Patient abuse
Compliance programs are an effective approach to mitigate liability.
TRUE
In a criminal investigation, a health care entity may advise its staff of their right to request counsel before responding and request their staff not to respond to investigators.
TRUE
When exclusion from the Medicare program is permissive, the provider has the option to adopt a corrective action plan instead of exclusion.
TRUE
Advisory opinions from federal agencies are frequently and easily obtained. Most agencies grant advisory opinions to communicate regulatory expectations to the broader provider audience.
FALSE
The government assumes that all bills submitted for payment are certified by the provider as compliant, which then enables the government to use the False Claims Act when challenging suspect claims.
TRUE
Stark Law penalties can include exclusion from the Medicare or Medicaid programs, where the physician knowingly entered into an improper arrangement.
TRUE
The False Claims Act only applies to the submission of claims by health care providers to the government.
FALSE
The OIG publishes Fraud Alerts that can be used as guidance for providers to assess what type of conduct is prohibited or suspicious.
TRUE
Settlements offer a defendant the benefit of avoiding admission of liability.
TRUE
