Which term refers to an entity that conducts independent reviews under compliance arrangements?

Which term refers to an entity that conducts independent reviews under compliance arrangements?

• A. Independent Review Organization (IRO)
• B. Office of Inspector General (OIG)
• C. Corporate Integrity Agreement (CIA)
• D. Self Disclosure Protocol (SDP)

Answer: (D)

The concept being tested is identifying the external, objective reviewer used to assess a compliance program. An Independent Review Organization, or IRO, is specifically an external entity contracted to perform unbiased reviews of a provider’s compliance practices, audits, and claims processes. The goal is to produce independent findings about how well the program is working, identify gaps, and help the organization improve controls while maintaining objectivity. The other terms relate to different roles or processes: the Office of Inspector General (OIG) is a government office that oversees compliance and enforcement activities, not an external reviewer contracted to perform routine independent audits. A Corporate Integrity Agreement (CIA) is a legal agreement with the government outlining required compliance obligations, not a review entity. The Self Disclosure Protocol (SDP) is a process for voluntarily disclosing potential noncompliance to the OIG and cooperating in investigations, not a party that conducts independent reviews.

The concept being tested is identifying the external, objective reviewer used to assess a compliance program. An Independent Review Organization, or IRO, is specifically an external entity contracted to perform unbiased reviews of a provider’s compliance practices, audits, and claims processes. The goal is to produce independent findings about how well the program is working, identify gaps, and help the organization improve controls while maintaining objectivity.

The other terms relate to different roles or processes: the Office of Inspector General (OIG) is a government office that oversees compliance and enforcement activities, not an external reviewer contracted to perform routine independent audits. A Corporate Integrity Agreement (CIA) is a legal agreement with the government outlining required compliance obligations, not a review entity. The Self Disclosure Protocol (SDP) is a process for voluntarily disclosing potential noncompliance to the OIG and cooperating in investigations, not a party that conducts independent reviews.