Certified Professional Compliance Officer (CPCO) Course

The CPCO course is designed for experienced healthcare professionals and covers the many aspects of compliance. This training course covers the critical requirements for developing, implementing, and monitoring a healthcare compliance program for your practice based on governmental regulatory guidelines, such as internal compliance reviews, audits, risk assessments, and staff education and training. Prior to enrolling in this course, a minimum of two years of experience in a healthcare-related position is strongly recommended. The Certified Professional Compliance Officer (CPCO) certification addresses the ever-increasing compliance needs of government laws, regulations, rules, and guidelines. Medical practices require personnel capable of developing, organizing, managing, and directing the functions of a compliance department.

 

Employers recognize your understanding of the key requirements necessary to effectively develop, implement, and monitor a healthcare compliance program for your practice based on governmental regulatory guidelines by passing the CPCO exam, which includes internal compliance reviews, audits and risk assessments, and staff education and training.

 

Obtaining a CPCO credential demonstrates that you have:

 

  • The Office of Inspector General’s (OIG) compliance guidance for individual and small group physician practices, clinical laboratories, and third-party billing companies will be known to CPCOs.
  • The effectiveness of compliance programs.
  • The False Claims Act, Stark Laws, and Anti-kickback Statute, as well as the associated penalties, are examples of key healthcare fraud and abuse laws.
  • How the ACA will impact medical practices
  • Other laws and regulations, such as HIPAA, the Emergency Medical Treatment and Labor Act (EMTALA), the Occupational Safety and Health Administration (OSHA), and the Clinical Laboratory Improvement Amendments Act (CLIA), are in place (CLIA)
  • Investigation management, including self-disclosure protocols
  • Corporate Integrity Agreement (CIA) and Certificate of Compliance Agreement (CCA) requirements (CCAs)
  • Recovery Audit Contractors (RACs), Unified Program Integrity Contractors (UPICs), and Medicaid fraud control units are examples of current investigative activities (MFCUs)
  • Gifts/gratuities, conflicts of interest, use of advance beneficiary notices, teaching physicians’ guidelines, and incident-to services are all risk areas.

 

Erendiz Academy and CPCO Training:

 

The Certified Professional Compliance Officer (CPCO) credential addresses the ever-growing compliance requirements of government laws, regulations, rules, and guidelines. CPCO helps to manage increased scrutiny of Medicare and Medicaid fraud and abuse and the forthcoming requirement for obligatory physician practice compliance programs, they are an important part of keeping physicians free from legal issues. By learning CPCO course from Erendiz Academy, you will be able to improve the compliance knowledge of nearly all healthcare practices by applying your proven knowledge of coding and documentation guidelines. Erendiz Academy, being the good institute for CPCO online and classroom training, aims to give you with the best training to pass the CPCO certification exam with a high score.

 

AAPC’s CPCO New Exam Structure:

 

  • 100 multiple choice questions (proctored)
  • 4 hours to finish the exam
  • Open Code Books (manuals)
  • 70% passing score required

 

Mode of Training

 

  • Online
  • Classroom

 

The CPCO Exam Breakdown Structure

Topics

Areas

Exam Questions

Healthcare Compliance Program History

  • History of healthcare laws in the United States
  • Past healthcare industry investigations
  • Federal Sentencing Guidelines
  • Implementation of Compliance Program Guidance
  • Key agencies involved in healthcare compliance
  • Current statistics related to CERT reports and National Healthcare Expenditures
  • OIG five-principle strategy

5

OIG Compliance Program Guidance  

  • Physicians and Small Group Practices
  • General guidance information
  • The seven “steps”

                  o   Standards of conduct and operational policies

                  o   Oversight requirements

                  o   Compliance training

                  o   Monitoring and auditing

                  o   Communications

                  o   Disciplinary actions

                  o   Responding to detected offenses

22 

Compliance Program Guidance for

Third Party Billing Companies and Clinical Laboratories

  • Lab orders and billing
  • Balanced Budget Act of 1997 and diagnoses
  • Use of outside billing companies

3

OIG Supplemental Compliance Program Guidance for Hospitals

·         Supplemental hospital guidance

3

Key and other risk areas

  • Physician compliance program guidance risks
  • Documentation
  • Conflict of interest
  • Gifts/gratuities
  • Medical necessity
  • Advance Beneficiary Notices
  • Incident to
  • Overpayments/credit balances
  • Certificates of Medical Necessity
  • Certifications for Home Health & Therapy services
  • Billing of non-covered services as if covered
  • Teaching physicians
  • Gain sharing arrangements
  • Joint Ventures
  • Limiting charges for PAR and Non-PAR practices
  • Professional Courtesy/Discounts/Adjustments
  • Rental of office space
  • Unlawful advertising
  • State escheat laws

19

Fraud and Abuse Laws

  • Difference between fraud and abuse
  • Civil Monetary Penalties
  • False Claims Act
  • Anti-kickback Statute
  • Stark Laws
  • Fraud Enforcement and Recovery Act (FERA)
  • Patient Protection and Affordable Care Act (PPACA/Health Reform)

12

Other Laws and Regulations

  • HIPAA
  • EMTALA
  • CLIA
  • OSHA
  • RICO (Racketeer Influenced and Corrupt Organizations Act)
  • Mail/Wire fraud

24

Investigations Process/Audits

  • Subpoenas and search warrants
  • Use of legal counsel
  • Self-disclosure protocol
  • Qui tam/whistleblowers
  • Corporate Integrity Agreements (CIAs)
  • Certification of Compliance Agreements (CCAs)
  • Excluded Parties (OIG and GSA)
  • RACs, UPICS, MICs, PSCs, and MFCUs

9

References/Resources

  • Federal regulations/citations/references
  • Office of Inspector General
  • Centers for Medicare & Medicaid Services
  • Medicaid & Workers Compensation

3

||CPCO Exam||Total 100 Questions ||4 Hours||Open Code Book ||