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Chc Exam – Definitions (Verified)

1. Anti-Kickback Law

ANS> Prohibits the solicitation, receiving, offering, or paying of any remuneration directly or indirectly in cash or

in kind in exchange.

2. Audit - Baseline

ANS> A systematic inspection of records, policies, and procedures with the goal to establish a set of benchmarks for

comparison for future inspections.

3. Audit - Concurrent

ANS> An ongoing inspection of records, policies, and procedures at a given point in time in which identified potential

problems are investigated as they arise

4. Audit - Retrospective

ANS> A comprehensive inspection of records, policies, and procedures done usually in anticipation of launching a

compliance and ethics program. All potential problems are identified and then investigated.

5. Balanced Budget Act of 1997

ANS> Legislation containing major reform of the Medicare and Medicaid programs. Especially in home health and

patient transfers. Mandated permanent exclusion from participation in federally funded health care programs of those

convicted of three health care related crimes (3 strikes you're out)

6. Benchmarking

ANS> The measurement of performance against "best practice" stan- dards.

7. Best Practices

ANS> Generally recognized superior performance by organizations in operational and/or financial processes.

8. Business Associate

ANS> Person or organization that performs or assists in the performance of a function or activity involving the use

or disclosure of identifiable health information on behalf of a convered entity or provides services such as legal, actuatial,

accounting, consulting, data aggregation, management administration, accreditation or financial services to or for a

covered entity.

9. Caremark International Derivative Litigation