Healthcare Compliance Laws 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 Healthcare Compliance Laws flashcards as text
Under the Exclusion Statute, which OIG exclusion type is mandatory and has no discretion for waiver?
Answer: Exclusion following conviction of program-related crimes
Mandatory exclusions under 42 U.S.C. § 1320a-7(a) are triggered by convictions for program-related crimes, patient abuse, felony healthcare fraud, and controlled substance felonies — the OIG has no discretion to waive these.
The HITECH Act extended HIPAA obligations directly to which class of entities that were not previously directly regulated?
Answer: Business associates
HITECH made business associates directly subject to HIPAA's Security Rule and many Privacy Rule provisions, and created direct liability for breaches caused by business associates.
A hospital discovers a billing error that resulted in overpayments from Medicare over the past 18 months. Under the 60-day rule, when must repayment be initiated?
Answer: Within 60 days of identification and quantification of the overpayment
The 60-day rule (ACA Section 6402) requires that identified overpayments be reported and returned within 60 days of the date the overpayment is identified, or the date any corresponding cost report is due, whichever is later.
Under the Deficit Reduction Act of 2005, which entities are required to establish written policies educating employees about the False Claims Act?
Answer: Entities receiving $5 million or more annually in Medicaid payments
The Deficit Reduction Act requires entities receiving $5 million or more in annual Medicaid payments to establish written policies informing employees about the FCA and the entity's policies for detecting fraud and abuse.
Which standard governs how healthcare organizations must safeguard electronic protected health information (ePHI) under federal law?
Answer: HIPAA Security Rule
The HIPAA Security Rule establishes national standards for protecting ePHI through administrative, physical, and technical safeguards.
Under the Beneficiary Inducement provisions of the CMPL, offering Medicare beneficiaries free transportation to a clinic is generally permissible when it meets which condition?
Answer: It falls within an applicable safe harbor such as the local transportation safe harbor
OIG's local transportation safe harbor permits free or discounted transportation for beneficiaries to receive items or services, provided certain conditions including mileage limits and non-marketing restrictions are met.
Which federal law prohibits discrimination by healthcare providers receiving federal financial assistance on the basis of race, color, or national origin?
Answer: Title VI of the Civil Rights Act of 1964
Title VI of the Civil Rights Act of 1964 prohibits discrimination based on race, color, and national origin in programs and activities receiving federal financial assistance, including most healthcare providers.