IAHCSMM Chapter 16 Health Care
Regulation and Compliance Exam Review
Questions and Answers 100% Pass |
Graded A+
David Mungai [Date] [Course title]
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IAHCSMM Chapter 16 Health Care Regulation and Compliance Exam Review, Exams of Community Health
A comprehensive review of the key topics covered in iahcsmm chapter 16, which focuses on health care regulation and compliance. It covers the main federal agencies responsible for enforcement, the definitions and common forms of fraud and abuse, the relevant laws and regulations such as the false claims act, anti-kickback statute, and stark law, as well as the emergency medical treatment and active labor act (emtala) and antitrust issues. The document also discusses the importance of corporate compliance plans and the role of data analytics in detecting fraud and abuse trends. This review is designed to help students and professionals prepare for the iahcsmm chapter 16 exam and gain a thorough understanding of the regulatory landscape in the healthcare industry.
Typology: Exams
2024/2025
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IAHCSMM Chapter 16 Health Care
Regulation and Compliance Exam Review
Questions and Answers 100% Pass |
Graded A+
David Mungai [Date] [Course title]
IAHCSMM Chapter 16 Health Care
Regulation and Compliance Exam
Review Questions and Answers 100%
Pass | Graded A+
What three federal agencies do most of enforcement? - Answer>> -department of justice -department of health and human services, office of inspector general -centers of medicare and medicaid services what is fraud? - Answer>> intentional act of deception What is abuse? - Answer>> consists of improper acts that are unintentional but inconsistent with standard practices common forms of fraud and abuse - Answer>> -false claims -duplicate dibiling -up coding -kickbacks for referrals what is the false claims act? - Answer>> the federal gov primary civil remedy against fraudulent claims for payment What is anit-kickback statute - Answer>> Law of choice for federal enforcement authorities. imposes criminal liability what is the stark law (physician self-referral law) - Answer>> law developed to prohibit physicans from referring their pt to providers in which they have a financial interest (does not require proof of intent)
what is the clayton act - Answer>> prohibits merges and acquisitions that may lessen competition in any line of commerce what is the federal trade commission act - Answer>> prohibits unfair methods of competition. what is the adoption of a corporate compliance plan - Answer>> helps limit the risk of compliance errors and limits the liability of management and directors What do large data bases and corporation of health insurance companies offer? - Answer>> more opportunities for discerning trends in fraud promise of big data analytics promise the following - Answer>> -assess payment risk -over-utilization of servicies -pt enrolled in multiole states -geographic dispersion of pt and providers What is the difference between a compliance program and an integrity program? - Answer>> A compliance program focuses on laws and regulations; an integrity program focuses on ethics and values. What are the four basic functions of a compliance program? - Answer>> Prevention, detection, collaboration and enforment Which federal department directs the Office of Inspector General?
- Answer>> The Department of Health and Human Services