Cigna Compliance Exam 2024 | Quizlet

Which of the following is a reason why the the Compliance Department conducts internal and external audits?

To verify that everyone is licensed and appointed.

To identify areas of risk and compliance with Federal and State regulatory guidelines.

To monitor the number of enrollments that each person has completed.

None of the above.

To identify areas of risk and compliance with Federal and State regulatory guidelines.

HIPAA rules apply to "business associates", in addition to health plans and providers. Which of the following are included under "business associates"?

Employees and subcontractors such as contracted sales agents and brokers.

Lead Generation Services.

Company board of directors

Personal health record vendors.

Employees and subcontractors such as contracted sales agents and brokers.

Shelly, a broker agent, shares the same office space and equipment with her real estate agent sister, Simone. Simone often provides MA leads to Shelly and both cooperate closely together. Considering their family and professional ties, which of the following safeguards are necessary for Shelly to implement in securing beneficiaries' data?

Refraining from disclosing confidential information in phone conversations when others are present.

Store all protected, printed information in a locked cabinet that is separate from her sister's.

Both A&B.

None of the above.

Both A&B.

Which of the following forms of PHI is covered under HIPAA?

Can be spoken, on paper, or electronically stored and transmitted.

Oral, handwritten and printed information.

Printed information and information contained on a computer hard drive only.

Only handwritten information.

Oral, handwritten and printed information.

Which of the following are examples of how to keep your technology devices secure?

Secure your wireless connection before transmitting PHI wirelessly via the internet.

Do not share your user ID and password with anyone unless a co-worker who needs to access content on your computer.

Never share your login details with anyone

Both A. and C.

Both A & C

Which of the following statements is true of the HITECH act?

It lowered the civil monetary penalty structure for violations

It reduced privacy and security provisions found in the original HIPAA Privacy and Security rules.

It eliminated the criminal penalty for business associates of covered entities like Cigna from any direct liability with all HIPAA Security and Privacy Rules requirements.

It made business associates of covered entities directly liable for compliance with certain HIPAA Security and Privacy Rules.

It made business associates of covered entities directly liable for compliance with certain HIPAA Security and Privacy Rules.

Which of the following are examples of protected or confidential information

Past, present or future physical or mental health or condition.

Provision of health care to the individual.

Past, present, or future payment for the provision of healthcare to the individual.

All of the above.

All of the above.

Which of the following statements is accurate?

Cigna's goal is for only employed sales agents to practice compliance daily in the course of representing the company.

Employees of Cigna must comply with all federal and state legal and regulatory requirements while broker agents only need to comply with the legal and regulatory requirements of the state or states they are licensed in.

Cigna's goal is for all sales agents to practice compliance daily in the course of representing the company.

Unlike employees, broker agents are not a critical part of the Cigna compliance culture.

Cigna's goal is for all sales agents to practice compliance daily in the course of representing the company.

Which of the following best describe the auditing and monitoring programs of the Sales Development Action Program (SDAP)?

Cigna does not have a Sales Integrity team or a monitoring program.

Sales Integrity monitors data pertaining to internal agents' sales only.

Sales Integrity monitors data pertaining to the sale of Cigna products and potential violations of state, federal or Cigna policy.

Sales Integrity monitors data pertaining to external agents' sales only.

Sales Integrity monitors data pertaining to the sale of Cigna products and potential violations of state, federal or Cigna policy.

What is the first step if the SDAC committee determines a violation is founded?

The agent will be suspended.

The agent will be required to participate in a Ride-Along.

The agent will be required to undergo remediation.

The agent will be terminated.

The agent will be required to undergo remediation

Brandon, a sales agent completed the review of Cigna policies and procedures and signed the attestation to comply last year. Will Brandon be required to complete the review and attestation again this year?

All sales agents of Cigna are contractually obligated to review and abide by the policies and procedures and sign an attestation yearly.

Only direct employees of Cigna are contractually obligated to review the policies and procedures and sign an attestation yearly.

Cigna does not have any policies, procedures reviews, and/or attestation requirements for broker agents.

No, the attestation is only a one-time requirement and is not required yearly.

All sales agents of Cigna are contractually obligated to review and abide by the policies and procedures and sign an attestation yearly.

Kate, a broker sales agent, suspects a disclosure of a member's PHI and decides to report her suspicion to the privacy officer. Turns out after investigation that there really was no disclosure of PHI. Which of these options appropriately describes her actions?

She did the right thing; reasonable suspicions of disclosure of PHI should be reported.

She should have been a bit more restrained. She ended up wasting the investigators' time.

She should have made certain that there was a disclosure before reporting.

She should have reported only to her manager, never to the privacy officer.

She did the right thing; reasonable suspicions of disclosure of PHI should be reported.

Which of the following best describes the term "minimum necessary" in reference to PHI?

Use only the minimum PHI necessary to conduct business.

Minimize how many times PHI can be shared within a month.

Minimize delays when PHI is requested.

Distribute PHI to the minimum number of requestors.

Use only the minimum PHI necessary to conduct business.

Cigna provides well-publicized disciplinary standards. Which of the following represents all the disciplinary actions that employees, contracted agents, and subcontractors who do not comply with CMS and Cigna's rules, regulations, policies and procedures may face?

Financial penalties.

Suspensions and written warnings.

Terminations and financial penalties.

Verbal/written warnings, reprimands, suspensions, terminations, and financial penalties.

Verbal/written warnings, reprimands, suspensions, terminations, and financial penalties.

Which of the following are goals of the Compliance department?

Correct compliance problems promptly and effectively.

Reduce the potential for re-occurrence.

Ensure ongoing compliance.

All of the above.

All of the above