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CPMA EXAM PREP 2026 – 200 REAL EXAM QUESTIONS & DETAILED ANSWERS | CERTIFIED PROFESSIONAL MEDICAL AUDITOR STUDY GUIDE

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Pass the AAPC CPMA exam on your first attempt with the newest 2026 test bank featuring 200 real exam questions, verified answers, and clear regulatory rationales. Covers all domains: fraud vs. abuse, False Claims Act, Stark & Anti-Kickback laws, OIG compliance programs, audit methodologies, coding guidelines (NCCI, MUE, E/M), statistical sampling, RAC audits, and corrective action plans. Written for medical auditors – your complete pass guarantee.

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CPMA EXAM NEWEST 2026 PACKAGE DEAL|

DIFFERENT VERSIONS WITH COMPLETE 800 REAL

EXAM QUESTIONS AND CORRECT DETAILED ANSWERS

(VERIFIED ANSWERS) ALREADY GRADED A+| CPMA

FINAL EXAM PREP 2026/2027 (BRAND NEW!!)



1. What is the difference between fraud and abuse according

to CMS definitions?

A. Fraud involves unintentional errors; abuse involves intentional

deception

B. Fraud involves knowingly misrepresenting facts to obtain

payment; abuse results in unnecessary costs without intent

C. There is no legal difference; the terms are interchangeable

D. Fraud applies only to Medicare; abuse applies only to

Medicaid


1

,Answer: B – Fraud involves knowingly misrepresenting facts

to obtain payment; abuse results in unnecessary costs without

intent

Rationale: CMS defines fraud as making false statements or

misrepresenting facts knowingly to obtain an undeserved benefit.

Abuse is defined as actions that result in unnecessary costs to a

federal healthcare program, either directly or indirectly, without the

knowledge/intent element of fraud .

2. Which of the following is an example of CMS-defined

fraud?

A. Misusing codes on a claim

B. Billing for services not medically necessary

C. Billing for services that were not furnished

D. Failure to maintain adequate medical records

Answer: C – Billing for services that were not furnished

Rationale: CMS examples of fraud include billing for

2

,services/supplies known not to be furnished, altering claim forms

for higher payment, billing for higher level services than provided,

and misrepresenting diagnoses. Misusing codes, unnecessary

services, and poor records constitute abuse, not fraud .

3. What is the penalty range under the current False Claims

Act (FCA) per false claim?

A. 1,000–5,000

B. 5,500–11,000

C. 10,000–20,000

D. 50,000–100,000

Answer: B – 5,500–11,000 per claim

Rationale: The False Claims Act imposes penalties ranging

from 5,500𝑡𝑜11,000 per false claim, plus treble damages (three

times the amount of damages sustained). These penalties are

adjusted periodically for inflation .


3

, 4. Under the False Claims Act, a person may be liable if they

knowingly present a false claim. What does "knowingly"

include?

A. Only actual knowledge of falsity

B. Deliberate ignorance or reckless disregard of truth or falsity

C. Only willful intent to defraud

D. Negligent billing errors

Answer: B – Deliberate ignorance or reckless disregard of truth

or falsity

Rationale: The FCA defines "knowingly" to include actual

knowledge, deliberate ignorance of the truth or falsity of the

information, and reckless disregard of the truth or falsity. No

specific intent to defraud is required .

5. The False Claims Act allows for reduced penalties if certain

conditions exist. These conditions include:

A. The person self-discloses within 30 days of obtaining violation

4

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