Compliance Training Quiz: MCQ Trivia!
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NMI's Compliance Program sets forth the means by which the Code of Conduct is to be implemented and monitored.
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True
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False
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Compliance training quiz: MCQ trivia! It is important for a place of work or a profession to have some rules they should abide in. In the quiz below, you will test if you understood the topics covered in training. Do give them a look and see if the options you choose are expected of someone in your position of not. All the best and work on what you get wrong!
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- 2.
NMI's Compliance Program describes the steps Nationwide Medical Inc. has taken to ensure compliance with the code.
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True
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False
Correct Answer
A. TrueExplanation
The statement is true because the Compliance Program describes the actions that Nationwide Medical Inc. has implemented to ensure compliance with the code. This program outlines the steps and measures taken by the company to adhere to the regulations and guidelines set forth in the code.Rate this question:
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- 3.
NMI’s Code of Conduct is a statement of policy that applies to ALL employees and contractors.
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True
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False
Correct Answer
A. TrueExplanation
The NMI's Code of Conduct is a statement of policy that applies to all employees and contractors. This means that all individuals working for NMI, whether they are employees or contractors, are required to adhere to this code. Therefore, the statement "True" is correct as it accurately reflects the fact that the Code of Conduct applies to all employees and contractors.Rate this question:
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- 4.
Since NMI has a Compliance Officer, you only need to concern yourself with your day-to-day activities and not concern yourself with complying with all policies and procedures.
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True
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False
Correct Answer
A. FalseExplanation
The statement suggests that since NMI has a Compliance Officer, individuals do not need to worry about complying with policies and procedures in their day-to-day activities. However, this is incorrect. Regardless of the presence of a Compliance Officer, it is still important for individuals to be aware of and comply with all policies and procedures in their daily activities to ensure adherence to regulatory requirements and maintain a culture of compliance within the organization.Rate this question:
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- 5.
NMI's Compliance Program generally identifies substantive risk areas and NMI's approach to addressing such risks.
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True
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False
Correct Answer
A. TrueExplanation
The statement is true because NMI's Compliance Program is designed to identify and address substantive risk areas. This means that the program is proactive in identifying potential risks and implementing measures to mitigate them. By doing so, NMI ensures that it is compliant with relevant regulations and can effectively manage any potential risks that may arise.Rate this question:
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- 6.
NMI's Compliance Program meets the requirements of Corporate Sentencing Guidelines and is designed to generally be effective in preventing and deterring criminal conduct.
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True
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False
Correct Answer
A. TrueExplanation
The given statement is true. NMI's Compliance Program is designed to meet the requirements of Corporate Sentencing Guidelines, which means it is in line with the standards set for preventing and deterring criminal conduct. This implies that the program is effective in ensuring compliance and preventing any illegal activities. Therefore, the statement is correct.Rate this question:
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- 7.
HIPAA stands for:
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Health Insurance Portability Act of America
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Health Insurance Portability and Accountability Act
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Hi-Tech Insurance Portability Accountability Act
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Health Insurance Purchase and Accounting Act
Correct Answer
A. Health Insurance Portability and Accountability ActExplanation
HIPAA stands for the Health Insurance Portability and Accountability Act. This act was passed in the United States to ensure the protection and privacy of individuals' health information. It establishes standards for the electronic exchange, privacy, and security of health information. The act also includes provisions to safeguard the confidentiality of personal health records and sets penalties for violations. Therefore, the correct answer is Health Insurance Portability and Accountability Act.Rate this question:
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- 8.
The Progressive Discipline Structure applies to only non-management personnel.
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True
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False
Correct Answer
A. FalseExplanation
The explanation for the answer "False" is that the Progressive Discipline Structure does not apply exclusively to non-management personnel. It is a system that can be implemented for both non-management and management employees. This structure is designed to address and correct employee misconduct or performance issues through a series of escalating disciplinary actions, regardless of their position within the organization. Therefore, the statement that the Progressive Discipline Structure applies only to non-management personnel is incorrect.Rate this question:
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- 9.
All are examples of Fraud and Abuse, except:
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Falsely certifying that services were medically necessary
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Billing for durable medical equipment and/or supplies not delivered
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Accidentally disclosing a patient’s protected health information to another organization without an authorization from the patient.
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Soliciting, offering or receiving a kickback, bribe or rebate in exchange for patient referrals.
Correct Answer
A. Accidentally disclosing a patient’s protected health information to another organization without an authorization from the patient. -
- 10.
As a healthcare organization, NMI MUSTcomply because:
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Health care is highly regulated –specifically federal healthcare payor programs.
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Many activities that are perfectly legal in other industries are not legal in the health care field.
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Complying makes good business sense as an effective compliance program helps organizations identify and address specific risk areas.
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Federal and state governments are increasing enforcement actions against out-of-compliance providers and suppliers.
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All of the above.
Correct Answer
A. All of the above.Explanation
The given answer, "All of the above," is correct because all of the statements provided in the question support the need for NMI to comply as a healthcare organization. The healthcare industry is highly regulated, and activities that may be legal in other industries may not be legal in healthcare. Implementing an effective compliance program helps organizations identify and address specific risk areas, which is beneficial for business. Furthermore, there is an increasing number of enforcement actions by federal and state governments against providers and suppliers who are not in compliance. Therefore, NMI must comply for all of these reasons.Rate this question:
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- 11.
This law makes it illegal for providers to knowingly and willfully offering, paying, soliciting, or receiving, directly or indirectly, anything of value if the purpose is to ‘induce’ referrals.
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The Anti-kickback statute
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The Anti-solicitation provisions
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The Stark Law
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The False Claims Act
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Civil Monetary Penalty
Correct Answer
A. The Anti-kickback statuteExplanation
The correct answer is the Anti-kickback statute. This law prohibits providers from offering or receiving anything of value in exchange for referrals. It aims to prevent fraud and abuse in healthcare by ensuring that referrals are made based on the patient's best interest rather than financial incentives.Rate this question:
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- 12.
Nationwide’s risk of fraud and abuse arising out of?
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Our inability to respond to Medicare payor medical records demands.
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Our ability to pay for, or induce more referrals from our referral sources.
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Our relationships with referral sources and our submission of information to payers and regulatory agencies.
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The fact that healthcare is a highly regulated industry.
Correct Answer
A. Our relationships with referral sources and our submission of information to payers and regulatory agencies.Explanation
The correct answer is "Our relationships with referral sources and our submission of information to payers and regulatory agencies." This answer suggests that Nationwide's risk of fraud and abuse arises from their interactions with referral sources and their compliance with regulations when submitting information to payers and regulatory agencies. This implies that improper relationships with referral sources or inaccurate information submission can potentially lead to fraudulent activities or abuse within the organization.Rate this question:
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- 13.
pHI and PII stand for?
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Protected Health Information and Personally Indentifiable Information
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Protected Health Identification and Personally Identity Information
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Pro-rated Health Information and Purposeful Identifiable Information
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Private Health Information and Personal Information and Identity
Correct Answer
A. Protected Health Information and Personally Indentifiable InformationExplanation
PHI and PII stand for Protected Health Information and Personally Identifiable Information. These terms are commonly used in the context of data privacy and security, particularly in the healthcare industry. Protected Health Information refers to any information related to an individual's health status, healthcare provision, or payment for healthcare services. Personally Identifiable Information, on the other hand, refers to any data that can be used to identify an individual, such as their name, address, social security number, or medical record number. Both PHI and PII are subject to strict regulations and safeguards to ensure the privacy and confidentiality of individuals' personal and health-related data.Rate this question:
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- 14.
You work from 8am to 5 pm for NMI and then leave to work for a direct competitor from 6 pm to 10 pm. Is that a possible conflict of interest?
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Yes
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No
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Depends on the specifics of the job
Correct Answer
A. YesExplanation
Yes, working for a direct competitor while still being employed by NMI can be considered a conflict of interest. This is because the employee may have access to confidential information, trade secrets, or strategies of NMI that could be used to benefit the competitor. It may also create a divided loyalty between the two companies, compromising the employee's ability to act in the best interest of NMI.Rate this question:
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- 15.
The penalties for a Stark Law violation are
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Up to $15,000 for each service with the refund of illegal amounts added in
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5 years imprisonment and $10,000 for each claim billed in violation
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$25,000 and loss of federal provider status
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No penalties assessed
Correct Answer
A. Up to $15,000 for each service with the refund of illegal amounts added in -
- 16.
When you have a concern about a possible compliance violation, it’s best to contact only your direct supervisor.
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True
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False
Correct Answer
A. FalseExplanation
It is not best to contact only your direct supervisor when you have a concern about a possible compliance violation. In fact, it is recommended to report such concerns to the appropriate channels, such as the human resources department or a designated compliance officer, to ensure that the issue is addressed properly and impartially. Relying solely on your direct supervisor may not guarantee a fair resolution, as they could be involved in the violation or may not have the authority to address it effectively.Rate this question:
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- 17.
Compliance is defined as
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A yielding; as to a desire or a demand.
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The act of complying; a yielding; as to a desire, demand, or proposal.
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The act of complying; a yielding; as to a desire, demand, or proposal or concession.
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The act of complying; a yielding; as to a desire, demand, or proposal; concession; submission.
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All of the above
Correct Answer
A. The act of complying; a yielding; as to a desire, demand, or proposal; concession; submission.Explanation
The correct answer is "The act of complying; a yielding; as to a desire, demand, or proposal; concession; submission." This answer encompasses all the given definitions of compliance, which include yielding to a desire, demand, or proposal, as well as making concessions and submitting to something.Rate this question:
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- 18.
When are we allowed to use or disclose pHI without an authorization from the patient?
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During the course of treatment, payment and operations
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At any time, so long as we call and notify the patient
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Never, we always need an authorization from the patient
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It depends on state laws governing privacy information
Correct Answer
A. During the course of treatment, payment and operationsExplanation
Under the Health Insurance Portability and Accountability Act (HIPAA), healthcare providers are allowed to use or disclose Protected Health Information (PHI) without patient authorization for purposes of treatment, payment, and healthcare operations. This means that healthcare providers can share PHI with other healthcare professionals involved in the patient's treatment, with insurance companies for billing and reimbursement purposes, and for internal administrative activities such as quality improvement and staff training. However, it is important to note that there are certain limitations and restrictions on the use and disclosure of PHI even in these situations.Rate this question:
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- 19.
The applicable laws that can affect NMI’s business operations and compliance include the following, except:
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1.Federal Anti-kickback Statute
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2.Managed Health Care Laws
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3.Stark Law
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4.Medicare Anti-Solicitation Statute
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5.Medicare Anti-Inducement Statute
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6.State Anti-Kickback Statute
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7.False Claims Laws
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8.Civil Monetary Penalty Law
Correct Answer
A. 2.Managed Health Care LawsExplanation
The correct answer is 2. Managed Health Care Laws. This is because managed health care laws primarily regulate the operations and practices of health insurance companies and managed care organizations, rather than directly affecting the business operations and compliance of NMI. The other laws listed, such as the Federal Anti-kickback Statute, Stark Law, Medicare Anti-Solicitation Statute, Medicare Anti-Inducement Statute, State Anti-Kickback Statute, False Claims Laws, and Civil Monetary Penalty Law, are all applicable to NMI's business operations and compliance in various ways.Rate this question:
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- 20.
NMI’s Code of Conduct addresses all of the following risk areas, except:
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1.Compliance with Laws and Regulations
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2.Stock and securities trading
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3.Billing and Financial Accounting
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4.Conflicts of Interest
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5.Fraud Information
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6.Universal Healthcare
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7.Assignment of Inventions
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8.Physician Orders/Medical Documentation
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9.Confidential Business Information
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10.Employees’ Right and Obligations
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11.Privacy of Medical Information
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12.Health Insurance Premium Increases
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13.Marketing
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14.Antitrust and Trade Regulation
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15.Work Environment
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16.Homeland Security
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17.Reporting of Violations
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18.Discipline for Violations
Correct Answer(s)
A. 2.Stock and securities trading
A. 6.Universal Healthcare
A. 12.Health Insurance Premium Increases
A. 16.Homeland SecurityExplanation
The NMI's Code of Conduct addresses all areas of risk except for stock and securities trading, universal healthcare, health insurance premium increases, and homeland security. This means that the Code of Conduct does not provide specific guidelines or regulations regarding these areas. The Code of Conduct likely focuses on other areas such as compliance with laws and regulations, conflicts of interest, fraud information, confidential business information, employees' rights and obligations, privacy of medical information, marketing, antitrust and trade regulation, work environment, reporting of violations, and discipline for violations.Rate this question:
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Quiz Review Timeline (Updated): Mar 21, 2023 +
Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.
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Current Version
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Mar 21, 2023Quiz Edited by
ProProfs Editorial Team -
Nov 16, 2012Quiz Created by
Tai Asanuma
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