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CPCO Practice Exam | 50 Questions with 100% Correct Answers | Latest Update 2024 | Rated A+
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CPCO Practice Exam | 50 Questions with 100% Correct Answers | Latest Update 2024 | Rated A+
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CPCO Practice Exam | 50 Questions with 100% CorrectAnswers | Latest Update 2024 | Rated A+
False - ✔✔Physicians or suppliers who have chosen to accept assignment may as a result
collect from the enrollee or anyone else any amount which, when added to the benefit, may
exceed the Medicare allowed amount.
A. The lease would be commercially reasonable even if no referrals were made between the
parties and has a term or rental or lease for at least one 1 year.
B. The lease provides for a term of rental or lease for at least 1 year
C. The space rented or leased does not exceed that which is reasonable and necessary for
the legitimate business purposes of the lease or rental and is used exclusively by the lessee
when being used by the lessee
D. The rental charges over the term of the lease are set in advance, are consistent with fair
market value, and are not determined in a manner that takes into account the volume or value
of any referrals or other business generated between the parties - ✔✔According the Social
Security Act, Sec. 1877. [42 U.S.C. 1395], prohibitions on certain referral arrangements include
those that involve financial arrangements between entities and physician practices. In the law,
rental of office space is considered not to be a compensation arrangement under certain
conditions and as such are considered exceptions as long as which of the following exists?
True - ✔✔According to the Federal Register, the OIG has listed a number of potential risk
areas for physician practices. These risk areas include: (a) coding and billing, (b) reasonable
and necessary services, and (c) documentation. Which of the following scenarios would be
considered a risk area or areas for a physician practice?
, False Claims Act, Stark Laws, and Anti-kickback Statute - ✔✔There can be a variety of risks
associated with joint ventures between hospitals and physicians. What law(s) could be violated
for improper joint ventures?
Dr. Appleton's ownership in the orthopedic hospital represents a conflict of interest because
his decisions on the care needed by his patients may be biased by his potential financial gain
for referring patients to the facility. - ✔✔Dr. Appleton is an orthopedic surgeon in a large
orthopedic practice. Due to the success of their clinic, the practice is opening a new orthopedic
hospital that will be owned by all of the physicians in the group. In addition to Stark Law issues,
what other compliance concern may be present?
Fraud - ✔✔Physician Quack just completed a 15-minute psychiatric evaluation of his patient.
He intentionally completes his superbill for a 30-45-minute session. Dr. Quack may be liable for:
Up to three "times the amount of the damages which the Government sustains..." - ✔✔The civil
False Claims Act provides the Court with the authority to assess:
The physician practice should limit participation in a hospital's compliance program to training
and education or policies and procedures only. - ✔✔The Federal Anti-Kickback Statute places
certain constraints on business arrangements related directly or indirectly to items or services
reimbursed by any Federal health care program, including, but not limited to, Medicare and
Medicaid. According to the OIG, which of the following would likely be an acceptable practice?
Does the arrangement or practice raise patient safety or quality of care concerns? -
✔✔Although liability under the anti-kickback statute ultimately turns on a party's intent, it
is possible to identify arrangements or practices that may present a significant potential for
abuse. Which of the following questions would be helpful to determine whether a proposed
action could violate the anti-kickback statute?
E-Prescribing - ✔✔Section 101 of the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA) - Pub. L. 108-173, December 8, 2003 - authorized an exception
to the physician self-referral prohibition for certain arrangements in which the physician can
receive necessary non-monetary remuneration. What is this exception related to?
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