HIPAA
Fraud, Waste, and Abuse
Reporting
General Compliance
Hodgepodge
100
The acronym, H.I.P.A.A stands for this.
What is Health Insurance Portability and Accountability Act.
100
An intentional deception, false statement or misrepresentation made by a person with the knowledge that the deception could result in unauthorized benefit to oneself or another person.
What is Fraud.
100
An anonymous way for employees to report compliance issues/concerns.
What is the compliance hotline.
100
The name of the NY Compliance Officer.
Who is Felicia Jackson
100
This HIPAA rule allows only what is necessary to complete the job at hand.
What is Minimum Necessary Rule.
200
National standards to protect individuals' medical records and other personal health information by those health care entities that conduct certain health care transactions electronically.
What is the Privacy Rule.
200
This statute prohibits soliciting or receiving remuneration for referrals of Medicare or Medicaid patients, or referral for services or items which are paid for, in whole or in part, by Medicare or Medicaid.
What is the Anti-Kickback Statute.
200
A quarterly overview of how each region is doing with regard to compliance.
What is the Compliance Scorecard.
200
Quality assurance testing carried out over the day to day activities of the business
What is monitoring.
200
Name three (3) types of PHI identifiers.
What is: 1. name 2. address (city, state, zip) 3. social security number 4. driver's license 5. birth certificate number 6. all elements of dates (i.e. DOS) 7. phone numbers 8. fax numbers 9. medical record numbers 10. health plan beneficiary numbers 11. account numbers 12. full face photographic images
300
What PHI stands for.
What is Protected Health Information.
300
This law provides limitations on certain physician referrals.
What is Stark Law.
300
This policy states that no disciplinary action or other form of retribution shall be taken against any volunteer who, in good faith, reports an issue, problem, concern or violation to management, human resources, the Compliance Officer, or the hotline.
What is the non-retaliation policy.
300
UHC must comply with this governmental agency's regulations set forth in its Medicaid program.
What is CMS.
300
The only person who is allowed to know your MS password.
Who is yourself.
400
Under this rule, HIPAA establishes national standards to protect individuals' electronic personal health information that is created, received, used, or maintained by a covered entity.
What is the Security Rule.
400
An individual who reports illegal or fraudulent activity by an employer, government or organization.
What is a whistleblower or qui tam.
400
A process, effected by an entity's board of trustees, management, and other personnel, designed to provide reasonable assurance regarding the achievement of compliance objectives.
What is an Internal Control.
400
The result of an unauthorized access to, or collection, use or disclosure of personal information
What is a breach.
400
The address of the lower Manhattan UHC office.
What is 77 Water St.
500
This Act widens the scope of privacy and security protections available under HIPAA.
What is HITECH (Health Information Technology for Economic and Clinical Health).
500
A federal law that imposes liability on persons and companies who defraud governmental programs.
What is the False Claims Act.
500
The provisions that set forth the attributes of effective compliance and ethics programs included in the Federal Sentencing Guidelines for organizations.
What are the 7 Elements of Compliance.
500
This is UHC's compliance motto.
What is "Compliance is our rock".
500
A systematic process of evaluating the potential risks that may be involved in a projected activity or undertaking.
What is a risk assessment.
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