Regulatory Compliance and Government Oversight Questions and Answers Flashcards
6 cards from real CHC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Regulatory Compliance and Government Oversight Questions and Answers flashcards as text
What does the OIG's 'permissive exclusion' authority allow it to do, as opposed to mandatory exclusion?
Answer: Exclude individuals at the OIG's discretion based on conduct less serious than mandatory triggers
Permissive exclusion allows the OIG to exclude individuals or entities for conduct that is serious but does not automatically trigger mandatory exclusion, such as licensure revocations or excessive billing.
Which oversight body enforces the Emergency Medical Treatment and Labor Act (EMTALA)?
Answer: CMS
CMS is responsible for enforcing EMTALA, which requires hospitals participating in Medicare to provide stabilizing treatment to all patients regardless of ability to pay.
In healthcare compliance, what is the significance of the 'Sunshine Act' (Open Payments Program)?
Answer: It requires manufacturers to report payments and transfers of value to physicians and teaching hospitals
The Physician Payments Sunshine Act requires drug and device manufacturers to report payments and other transfers of value to physicians and teaching hospitals to CMS for public disclosure.
What is the statute of limitations for the government to bring a False Claims Act civil suit not involving a qui tam relator?
Answer: 6 years
The FCA provides a six-year statute of limitations for government-initiated civil actions, though it can extend to 10 years in qui tam cases depending on when the government knew or should have known of the violation.
A compliance officer discovers that a vendor is on the SAM.gov exclusion list. What is the appropriate immediate action?
Answer: Terminate or suspend the vendor relationship immediately to avoid program liability
Organizations must immediately suspend or terminate contracts with excluded vendors because payment for services rendered by excluded entities can result in civil monetary penalties and repayment obligations.
Which element of an effective compliance program does the OIG identify as critical for detecting potential violations early?
Answer: Maintaining open lines of communication including an anonymous hotline
The OIG's compliance guidance consistently emphasizes that open communication channels, including anonymous reporting hotlines, are critical for employees to report concerns without fear of retaliation.