PMPC Designation study plan

Map the seven elements of a compliance program to your own organization's written policies, flagging any element with no matching policy

Draft a one-page outline of the compliance committee charter, including membership, quorum, reporting lines, and meeting cadence

Explain in your own words how a compliance officer's authority and independence are protected within a governance structure

Identify three enforcement mechanisms (internal audit, external audit, government inquiry) and describe what triggers each

Sequence the steps of an internal investigation from intake through corrective action, and assign an owner to each step

Distinguish between a compliance risk, a compliance issue, and a compliance action, and classify ten realistic scenarios into those categories

Build a risk-scoring rubric using likelihood and impact, and apply it to five risks you identified in week 1

Describe how audit findings are tracked to closure, including documentation standards and escalation for overdue items

Compare the roles of the compliance officer, legal counsel, internal audit, and the board in detecting and responding to misconduct

Write a corrective action plan for one high-scored risk from week 2, specifying interim controls, root-cause analysis, and verification of effectiveness

Outline a training and communication plan that reaches staff, contractors, and vendors, including completion tracking

Practice documenting a compliance decision so it would withstand external review, including rationale and supporting evidence

Trace a claim from patient encounter through coding, charge entry, claim submission, and remittance, and label each handoff point where compliance risk concentrates

Differentiate coding accuracy obligations, medical necessity requirements, and documentation sufficiency, and give an example of a failure of each

Explain the structure of the Medicare Physician Fee Schedule, including relative value units and geographic adjustment, without reference to any external table

Identify the elements of a compliant billing edit and describe how an organization validates that its edits do not improperly suppress legitimate claims

Explain the difference between a coverage determination and a payment determination, and describe how each is appealed

List the core components of a compliance billing audit, including sample size logic, error rate calculation, and extrapolation cautions

Describe the roles of a carrier, a Medicare administrative contractor, and a recovery audit contractor in identifying and recovering improper payments

Draft the elements of a provider self-disclosure decision, including when disclosure is appropriate versus when internal correction suffices

Explain the statutory basis for Medicare exclusion and the difference between mandatory and permissive exclusion authorities

Describe the effect of exclusion on an organization, including what happens to claims for items or services furnished by an excluded individual and the organization's exposure

Identify the screening obligations an organization owes its employees and contractors, including the sources checked and the frequency of rescreening

Outline the steps an organization must take when it discovers it has employed or contracted with an excluded individual

Apply the elements of a compliance program specifically to exclusion risk, including written standards, training, monitoring, and disciplinary action

Describe how an excluded individual can seek reinstatement and what the organization's obligations are during a pending reinstatement request

Draft a board-level briefing on exclusion risk that quantifies exposure and requests a specific resource commitment

Analyze how exclusion interacts with other enforcement tools such as civil monetary penalties and corporate integrity agreements

Integrate the four domains into a single compliance program narrative that shows how governance, billing controls, risk management, and exclusion screening reinforce each other

Complete a timed practice set of at least sixty mixed-domain questions and categorize every miss by domain and by failure mode

Revisit every gap and risk item from weeks 1 through 7 and mark each as closed, in progress, or open with a next step

Build a one-page exam-day reference sheet of the concepts you most often missed, limited to what you can recall without notes