Compliance Risk Assessments Flashcards
7 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 7 Compliance Risk Assessments flashcards as text
A compliance officer interviews department heads and finds conflicting opinions on the severity of a billing risk. What is the BEST approach to resolve this?
Answer: Triangulate findings using claims data, audit results, and regulatory guidance
Triangulating multiple data sources provides an objective, evidence-based risk rating that is more reliable than any single opinion.
Under the HITECH Act, which type of organization is required to conduct a security risk analysis as part of compliance?
Answer: Covered entities and business associates handling electronic protected health information
HITECH expanded HIPAA requirements to business associates, making both covered entities and their business associates responsible for conducting security risk analyses.
A compliance risk assessment at a behavioral health clinic identifies high risk in medical record documentation. Which next step is MOST appropriate?
Answer: Design and implement a targeted audit and corrective action plan for documentation practices
High-priority findings from a risk assessment must be addressed through targeted audits and corrective action plans, not deferred or ignored.
Which component of a compliance risk assessment ensures that responsibilities for mitigating each identified risk are clearly assigned?
Answer: Risk ownership assignment
Assigning a specific risk owner to each identified risk ensures accountability and drives follow-through on mitigation efforts.
A compliance officer is presenting risk assessment findings to the board of directors. Which format is MOST effective for communicating the overall risk landscape?
Answer: A color-coded risk heat map with a summary of top 10 risks and proposed mitigations
A heat map with a top-risk summary gives board members a clear, actionable picture of priorities without overwhelming them with granular detail.
In third-party vendor management, why is it important to include vendors in a healthcare compliance risk assessment?
Answer: Vendors handling PHI or performing regulated functions create compliance exposure for the covered entity
Under HIPAA and the False Claims Act, covered entities can face liability for compliance failures occurring through their vendors, making vendor risk a key assessment area.
A compliance team wants to validate that their risk assessment methodology is consistent with industry standards. Which resource BEST supports this?
Answer: OIG Compliance Program Guidance and the COSO Enterprise Risk Management Framework
The OIG compliance program guidance and the COSO ERM framework together provide the most authoritative and widely accepted standards for healthcare compliance risk assessment methodology.