In 2017, the Fraud Section of the DOJ published a memorandum…

In 2017, the Fraud Section of the DOJ published a memorandum that addresses compliance-related topics. Which of the following compliance-related topics involves asking the questions “What training have employees in relevant control functions received?” and “What analysis has the company undertaken to determine who should be trained and on what subjects?”

When different hospitals within a peer group provide similar…

When different hospitals within a peer group provide similar services, such as wound debridement, chemotherapy infusion or injections, or laceration repairs, which of the following files containing information about the frequency of use of the corresponding CPT/HCPCS codes for these services can be consulted to compare and determine whether the code frequency in a specific hospital is reasonable for a particular service?

The CDI program manager is responsible for creating and main…

The CDI program manager is responsible for creating and maintaining the department policies and procedures that include the industry guidance from DOJ, OIG, and the Cooperating Parties. What is one question to ask when designing compliance policies and procedures?