1. Which of the following best describes what the Anti-Kickback Statute (AKS) prohibits?
a) A physician referring a patient to an entity they own, even if medically necessary
b) Offering, paying, soliciting, or receiving anything of value to induce or reward referrals for
Federal health care program business
c) Billing for a service that was never performed
d) Failing to maintain an updated enrollment record with CMS
Correct answer: Offering, paying, soliciting, or receiving anything of value to induce or reward
referrals for Federal health care program business
Rationale: The AKS explicitly prohibits any remuneration in exchange for referrals or generating
business from any Federal health care program.
2. Under the Anti-Kickback Statute, from whom can a referral originate to trigger a violation?
a) Only from a physician
b) Only from a Medicare beneficiary
c) From anyone
d) Only from a hospital administrator
Correct answer: From anyone
Rationale: The AKS applies to referrals from any person, not limited to physicians, making it
broader than the Stark Law.
3. The Anti-Kickback Statute applies to which of the following?
a) Only durable medical equipment
b) Only physician services
c) Any items or services payable by a Federal health care program
d) Only inpatient hospital services
Correct answer: Any items or services payable by a Federal health care program
Rationale: The statute covers any item or service that may be paid for in whole or in part by a
Federal health care program.
,4. To prove a criminal violation of the Anti-Kickback Statute, the government must establish:
a) Only that a payment was made
b) Intent (knowing and willful)
c) That the patient was harmed
d) That the service was medically unnecessary
Correct answer: Intent (knowing and willful)
Rationale: The AKS requires proof that the defendant acted knowingly and willfully, not merely
accidentally or negligently.
5. What is the maximum criminal fine per violation of the Anti-Kickback Statute?
a) 10, 000𝑏)25,000
c) 50, 000𝑑)100,000
Correct answer: 25,000 ∗∗
𝑅𝑎𝑡𝑖𝑜𝑛𝑎𝑙𝑒: 𝐶𝑟𝑖𝑚𝑖𝑛𝑎𝑙𝑝𝑒𝑛𝑎𝑙𝑡𝑖𝑒𝑠𝑢𝑛𝑑𝑒𝑟𝑡ℎ𝑒𝐴𝐾𝑆𝑖𝑛𝑐𝑙𝑢𝑑𝑒𝑓𝑖𝑛𝑒𝑠𝑢𝑝𝑡𝑜25,000 per violation plus up
to 5 years imprisonment.
6. In addition to criminal penalties, a violation of the Anti-Kickback Statute can result in:
a) Only a warning letter
b) False Claims Act liability, CMPs, and program exclusion
c) A mandatory compliance plan
d) Reduced future payments only
Correct answer: False Claims Act liability, CMPs, and program exclusion
Rationale: AKS violations trigger False Claims Act liability, civil monetary penalties up to
$50,000 per violation, assessments up to 3x the kickback amount, and possible exclusion.
7. The exceptions to the Anti-Kickback Statute are known as:
a) Mandatory exceptions
b) Safe harbors
c) Affirmative defenses only
d) De minimis exceptions
Correct answer: Safe harbors
Rationale: The AKS provides voluntary safe harbors that protect certain business arrangements
from liability if all criteria are met.
,8. The Anti-Kickback Statute applies to which health care programs?
a) Only Medicare
b) Only Medicare and Medicaid
c) All Federal Health Care Programs
d) Only commercial insurance
Correct answer: All Federal Health Care Programs
Rationale: The AKS covers all Federal health care programs, including Medicare, Medicaid,
TRICARE, and others.
9. Under the Stark Law, a physician is prohibited from referring a patient for designated health
services to an entity with which the physician (or immediate family) has a financial relationship,
unless:
a) The patient requests the referral in writing
b) An exception applies
c) The service is medically necessary
d) The entity is a hospital
Correct answer: An exception applies
Rationale: The Stark Law is a strict liability statute with specific mandatory exceptions; without
an applicable exception, the referral is prohibited.
10. The Stark Law prohibits an entity from:
a) Employing a physician who makes referrals
b) Submitting claims to Medicare for services resulting from a prohibited referral
c) Billing Medicaid for any outpatient service
d) Accepting cash payments from patients
Correct answer: Submitting claims to Medicare for services resulting from a prohibited referral
Rationale: The Stark Law bars the entity from billing Medicare or Medicaid for any designated
health service furnished pursuant to a prohibited referral.
11. Under the Stark Law, referrals are prohibited only when made by:
a) Any health care professional
b) A physician
c) A nurse practitioner
, d) A hospital discharge planner
Correct answer: A physician
Rationale: Stark Law applies specifically to referrals made by physicians (MDs, DOs, DDS,
DPM, etc.) for designated health services.
12. The Stark Law applies only to which payers?
a) All commercial insurers
b) Medicare and Medicaid (no commercial or TRICARE)
c) Only Medicare Part B
d) Only Medicaid managed care
Correct answer: Medicare and Medicaid (no commercial or TRICARE)
Rationale: The Stark Law is limited to referrals for services payable by Medicare or Medicaid; it
does not apply to commercial insurance or TRICARE.
13. Unlike the Anti-Kickback Statute, the Stark Law’s prohibition on overpayments has what
intent requirement?
a) Knowing and willful intent must be proven
b) No intent standard for overpayment (strict liability)
c) Only gross negligence
d) Intent to defraud is required
Correct answer: No intent standard for overpayment (strict liability)
Rationale: Stark imposes strict liability for overpayments; intent is not required to create an
overpayment obligation, though intent is required for CMPs.
14. A knowing violation of the Stark Law can result in a Civil Monetary Penalty (CMP) of up to:
a) 5, 000𝑝𝑒𝑟𝑠𝑒𝑟𝑣𝑖𝑐𝑒𝑏)15,000 per service
c) 50, 000𝑝𝑒𝑟𝑠𝑒𝑟𝑣𝑖𝑐𝑒𝑑)100,000 per service
Correct answer: 15,000𝑝𝑒𝑟𝑠𝑒𝑟𝑣𝑖𝑐𝑒 ∗∗
𝑅𝑎𝑡𝑖𝑜𝑛𝑎𝑙𝑒: 𝑇ℎ𝑒𝐶𝑀𝑃𝑓𝑜𝑟𝑎𝑘𝑛𝑜𝑤𝑖𝑛𝑔𝑆𝑡𝑎𝑟𝑘𝑣𝑖𝑜𝑙𝑎𝑡𝑖𝑜𝑛𝑖𝑠𝑢𝑝𝑡𝑜15,000 for each designated health
service billed.
15. The exceptions to the Stark Law are known as:
a) Safe harbors
b) Mandatory exceptions
a) A physician referring a patient to an entity they own, even if medically necessary
b) Offering, paying, soliciting, or receiving anything of value to induce or reward referrals for
Federal health care program business
c) Billing for a service that was never performed
d) Failing to maintain an updated enrollment record with CMS
Correct answer: Offering, paying, soliciting, or receiving anything of value to induce or reward
referrals for Federal health care program business
Rationale: The AKS explicitly prohibits any remuneration in exchange for referrals or generating
business from any Federal health care program.
2. Under the Anti-Kickback Statute, from whom can a referral originate to trigger a violation?
a) Only from a physician
b) Only from a Medicare beneficiary
c) From anyone
d) Only from a hospital administrator
Correct answer: From anyone
Rationale: The AKS applies to referrals from any person, not limited to physicians, making it
broader than the Stark Law.
3. The Anti-Kickback Statute applies to which of the following?
a) Only durable medical equipment
b) Only physician services
c) Any items or services payable by a Federal health care program
d) Only inpatient hospital services
Correct answer: Any items or services payable by a Federal health care program
Rationale: The statute covers any item or service that may be paid for in whole or in part by a
Federal health care program.
,4. To prove a criminal violation of the Anti-Kickback Statute, the government must establish:
a) Only that a payment was made
b) Intent (knowing and willful)
c) That the patient was harmed
d) That the service was medically unnecessary
Correct answer: Intent (knowing and willful)
Rationale: The AKS requires proof that the defendant acted knowingly and willfully, not merely
accidentally or negligently.
5. What is the maximum criminal fine per violation of the Anti-Kickback Statute?
a) 10, 000𝑏)25,000
c) 50, 000𝑑)100,000
Correct answer: 25,000 ∗∗
𝑅𝑎𝑡𝑖𝑜𝑛𝑎𝑙𝑒: 𝐶𝑟𝑖𝑚𝑖𝑛𝑎𝑙𝑝𝑒𝑛𝑎𝑙𝑡𝑖𝑒𝑠𝑢𝑛𝑑𝑒𝑟𝑡ℎ𝑒𝐴𝐾𝑆𝑖𝑛𝑐𝑙𝑢𝑑𝑒𝑓𝑖𝑛𝑒𝑠𝑢𝑝𝑡𝑜25,000 per violation plus up
to 5 years imprisonment.
6. In addition to criminal penalties, a violation of the Anti-Kickback Statute can result in:
a) Only a warning letter
b) False Claims Act liability, CMPs, and program exclusion
c) A mandatory compliance plan
d) Reduced future payments only
Correct answer: False Claims Act liability, CMPs, and program exclusion
Rationale: AKS violations trigger False Claims Act liability, civil monetary penalties up to
$50,000 per violation, assessments up to 3x the kickback amount, and possible exclusion.
7. The exceptions to the Anti-Kickback Statute are known as:
a) Mandatory exceptions
b) Safe harbors
c) Affirmative defenses only
d) De minimis exceptions
Correct answer: Safe harbors
Rationale: The AKS provides voluntary safe harbors that protect certain business arrangements
from liability if all criteria are met.
,8. The Anti-Kickback Statute applies to which health care programs?
a) Only Medicare
b) Only Medicare and Medicaid
c) All Federal Health Care Programs
d) Only commercial insurance
Correct answer: All Federal Health Care Programs
Rationale: The AKS covers all Federal health care programs, including Medicare, Medicaid,
TRICARE, and others.
9. Under the Stark Law, a physician is prohibited from referring a patient for designated health
services to an entity with which the physician (or immediate family) has a financial relationship,
unless:
a) The patient requests the referral in writing
b) An exception applies
c) The service is medically necessary
d) The entity is a hospital
Correct answer: An exception applies
Rationale: The Stark Law is a strict liability statute with specific mandatory exceptions; without
an applicable exception, the referral is prohibited.
10. The Stark Law prohibits an entity from:
a) Employing a physician who makes referrals
b) Submitting claims to Medicare for services resulting from a prohibited referral
c) Billing Medicaid for any outpatient service
d) Accepting cash payments from patients
Correct answer: Submitting claims to Medicare for services resulting from a prohibited referral
Rationale: The Stark Law bars the entity from billing Medicare or Medicaid for any designated
health service furnished pursuant to a prohibited referral.
11. Under the Stark Law, referrals are prohibited only when made by:
a) Any health care professional
b) A physician
c) A nurse practitioner
, d) A hospital discharge planner
Correct answer: A physician
Rationale: Stark Law applies specifically to referrals made by physicians (MDs, DOs, DDS,
DPM, etc.) for designated health services.
12. The Stark Law applies only to which payers?
a) All commercial insurers
b) Medicare and Medicaid (no commercial or TRICARE)
c) Only Medicare Part B
d) Only Medicaid managed care
Correct answer: Medicare and Medicaid (no commercial or TRICARE)
Rationale: The Stark Law is limited to referrals for services payable by Medicare or Medicaid; it
does not apply to commercial insurance or TRICARE.
13. Unlike the Anti-Kickback Statute, the Stark Law’s prohibition on overpayments has what
intent requirement?
a) Knowing and willful intent must be proven
b) No intent standard for overpayment (strict liability)
c) Only gross negligence
d) Intent to defraud is required
Correct answer: No intent standard for overpayment (strict liability)
Rationale: Stark imposes strict liability for overpayments; intent is not required to create an
overpayment obligation, though intent is required for CMPs.
14. A knowing violation of the Stark Law can result in a Civil Monetary Penalty (CMP) of up to:
a) 5, 000𝑝𝑒𝑟𝑠𝑒𝑟𝑣𝑖𝑐𝑒𝑏)15,000 per service
c) 50, 000𝑝𝑒𝑟𝑠𝑒𝑟𝑣𝑖𝑐𝑒𝑑)100,000 per service
Correct answer: 15,000𝑝𝑒𝑟𝑠𝑒𝑟𝑣𝑖𝑐𝑒 ∗∗
𝑅𝑎𝑡𝑖𝑜𝑛𝑎𝑙𝑒: 𝑇ℎ𝑒𝐶𝑀𝑃𝑓𝑜𝑟𝑎𝑘𝑛𝑜𝑤𝑖𝑛𝑔𝑆𝑡𝑎𝑟𝑘𝑣𝑖𝑜𝑙𝑎𝑡𝑖𝑜𝑛𝑖𝑠𝑢𝑝𝑡𝑜15,000 for each designated health
service billed.
15. The exceptions to the Stark Law are known as:
a) Safe harbors
b) Mandatory exceptions
