CPCO Practice Test

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CPCO Practice Test (V1)

Dive into practice questions

Question 1

According to the Health Insurance Portability and Accountability Act (HIPAA), which of the following is considered a permissible disclosure of Protected Health Information (PHI) by a pharmacy without patient authorization?

  1. Providing a patient’s medication list to a pharmaceutical company for marketing research.
  2. Sharing a patient’s diagnosis with a concerned neighbor.
  3. Submitting a claim to a patient’s insurance company for payment of a prescription.
  4. Posting a patient’s name and medication on the pharmacy’s social media page as a testimonial.

Question 2

Which of the following scenarios most clearly represents a potential violation of the federal Anti-Kickback Statute (AKS) in a pharmacy setting?

  1. Offering free delivery service to all patients in a specific zip code.
  2. Providing a free box of tissues with every prescription filled in December.
  3. A specialty pharmacy providing a physician’s office with free catered lunches every week in exchange for referring patients.
  4. Waiving a patient’s copayment after determining they have a financial hardship, in accordance with store policy.

Question 3

A pharmacy technician is newly hired. What is the most important reason for the pharmacy compliance officer to check the Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE) before the technician begins working?

  1. To verify the technician’s previous employment history.
  2. To determine the technician’s credit score.
  3. To ensure the technician is not excluded from participating in federal healthcare programs, which would prohibit the pharmacy from billing for any services they are involved in.
  4. To check if the technician has any active social media accounts.

Question 4

The OIG recommends that healthcare organizations, including pharmacies, adopt seven fundamental elements for an effective compliance program. Which of the following is one of those seven elements?

  1. Implementing written policies, procedures, and standards of conduct.
  2. Guaranteeing a minimum annual profit margin.
  3. Having a marketing budget that exceeds the previous year’s budget.
  4. Ensuring all employees are members of a national pharmacy association.

Answer Key

  • Question 1: C. Submitting a claim to a patient’s insurance company for payment of a prescription. (HIPAA allows for the disclosure of PHI for Treatment, Payment, and Healthcare Operations (TPO) without specific patient authorization for each instance.)
  • Question 2: C. A specialty pharmacy providing a physician’s office with free catered lunches every week in exchange for referring patients. (The AKS prohibits offering, paying, soliciting, or receiving anything of value to induce or reward referrals for items or services paid for by federal healthcare programs.)
  • Question 3: C. To ensure the technician is not excluded from participating in federal healthcare programs, which would prohibit the pharmacy from billing for any services they are involved in. (Employing an excluded individual can result in significant civil monetary penalties, as no federal healthcare program payments can be made for items or services furnished by that person.)
  • Question 4: A. Implementing written policies, procedures, and standards of conduct. (This is a cornerstone of an effective compliance program, providing a framework for employees to follow and setting the organization’s expectations for ethical behavior.)