Test Your Rules & Regulations Knowledge

Multiple Choice

1. This law is considered the "self referral" law and under this law, if a physician or a member of a physician's immediate family has a financial relationship with a healthcare entity, the physician may not make referrals to that entity for the furnishing of designated health services under the Medicare program. What is the name of this law?

a. Anti-kickback law

b. False Claims Act

c. Stark Law

d. Not an acutal law and is Medicare Guidelines

2. Which law prohibits individuals or entities from knowingly and willfully offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid or any other federally funded program?

a. False Claims Act

b. Anti-kickback law

c. Stark Law

d. OIG Compliance

3. These services are performed by a non-physician practitioner and can be billed to Medicare under the physicians NPI number. The supervising physician must be present in the office and supervise the non-physician practitioner. Billing these type of services is called?

a. Batch Billing

b. Incident-to services

c. Fee-for-services

d. Capitation

4. These type of tests are categorized as "simple laboratory examinations and procedures that have an insignificant risk of an erroneous result." These are tests that most offices are able to perform without sending to an outside laboratory. Offices must apply for this license and keep current accurate logs of tests performed. What is the name of this license?

a. ABN

b. DME



5. What is the name of a proactive program that ensures fulfilment with all applicable policies, procedures, laws and regulations. It is designed to detect and correct violations, provide employee training, routine physician auditing of documentation and establish standards and procedures that are reasonably capable of reducing the prospect of criminal conduct.

a. Compliance Plan


c. OIG Work Plan

d. Stark Laws

6. What is HIPAA?

a. Standardization of electronic health transactions

b. Privacy protection of individual health information

c. Security of health information for patient

d. All of the above


What is the general rule when a patient includes your facility in a bankrupcy?

a. Contact patient attorney and set up a payment plan

b. Dismiss patient within 30 days of notice and send to collections

c. You cannot have further contact with patient to collect payment

d. Contact your healthcare attorney to omit your facility from the bankrupcy procedure


Which answer below is not permitted?

a. Offer professional courtesy discounts

b. Offer financial hardships

c. Waive copays, only when necessary

d. Offer cash discounts for those who pay in full


Per OIG, all practices/facilities should have a Compliance Plan.  Per OIG what is require in a Compliance Plan?

a. These are written standards and procedures, to include internal monitoring, auditing, implementation of a compliance plan, designate a compliance officer, training for physicians and employees, detect offenses and develop corrective actions, develop open lines of communication, enforce disciplinary standards

b. Ensure employees work in a safe and healthful environment and enforcing standard by providing training, outreach an education. Employers must comply with all standards and keep workplace free of serious hazards

c. Information that prohibits discrimination against people with disabilities, all procedures for hiring, firing, advancement, compensation and job training, employee rights, disability assistance

d. Information that clearly defines employers and employees responsibilities to each other, equal right opportunities, terms and conditions of employment, health and safety, workers compensation laws and regulations, definitions of American with Disabilities Act, regulations of harassment and discrimination, FMLA regulations, health benefits, Overtime wages, employee ethics, employee leave policies


What is Meaningful Use?

a. Healthcare notice to patient protecting their health information from being disclosed to others, confidentiality restricting patient information to only those who require it and security of patient information

b. Healthcare and payers to implement electronic transaction standards which is a uniform language to include CPT, ICD-10-CM, HCPCS, CPT, NDC

c. Healthcare clinicians are required to show the EHR technology they are used to measure quality and quantity of care for patients and family, improve care coordination and public health, maintain patient privacy and security of their information, and reduce health disparities

d. Meaningful Use is required for Electronic Medical Records software companies to comply with HIPAA regulations


Dedicated to making positive changes in your life and career.