LIU Health & Medical Fundamentals of Healthcare Regulations & Compliance Questions

1. Choose one of the following agencies and summarize how they regulate the health care industry.

CMS

HHS

• OIG
• OSHA
• NCQA
• AHRQ
• 2. How is HEDIS data used to measure performance and quality?
• 3. How does the concept of quality, through HCQA and AHRQ, relate to compliance with regulations?

4. What is the difference between licensure and credentialing?

5. How do the antitrust laws impact health care services?

6. What are two concerns in treating health care as a business?

7. What is health care reform and why is it important?

8. Why is regulation in health care so complex?

9. How is accreditation used to assess the performance of a health care organization?

10. What are some of the difference between fraud and abuse?

11. List and define the seven requirements for a compliance plan.

12. Why is compliance planning important for a health care organization?

13. Choose two advance directives and summarize