RHIT PRACTICE EXAM 1 – 150 QUESTIONS
AND CORRECT ANSWERS 2026
REGISTERED HEALTH INFORMATION
TECHNICIAN STUDY GUIDE AHIMA EXAM
PREP
**A doctor bills Medicare (and falsifies medical records to support the
billing) for services he never provide to Jane Chen. Jane later becomes ill
and is admitted to the hospital. The doctors there rely on her medical
records in making decisions about her condition and her treatment, but
since these records are not accurate, the best medical outcome for Jane may
NOT be achieved.
**Agent Marco Martinez markets MA-PD plans by focusing solely on
premiums--stressing low monthly costs w/o mentioning the potentially
sizable cost sharing obligations that could be faced by a beneficiary. Maria
Sanchez opts for a lower premium policy and later forgoes needed medical
services because of her inability to pay the cost sharing involved in her
policy.
Legal Tools Against FWA (to Combat FWA) - CORRECT ANSWER-There
are several legal tools that the government can employ in its fight against
FWA, including the following statutes:
1. Federal Civil False Claims Act
2. Anti-Kickback Statute
3. Physician Self-Referral Law (Stark Legislation)
4. Criminal Health care Fraud Statute
5. Criminal False Statements Act
6. HIPPA and HITECH Act
,**Violations of these laws can result in non-payment of claims, imposition
of CIVIIL MONETARY PENALTIES, exclusions from the Medicare
program, imprisonment and criminal and civil liability.
The Federal Civil False Claims Act.
Criminal False Statements Act
**The US code provides that anyone who falsifies or conceals a material
fact, makes materially false statements or representations, or uses any false
documents knowing them to contain false statements in any matter within
the jurisdiction of the Executive Branch, which includes CMS, shall be fined
and imprisoned for up to 5 years.
**It would be a violation of this law if independent agents knowingly
provide MA and Part D plans with false information that they know will be
provided to CMS - CORRECT ANSWER-**The federal false claims act
PROHIBITS individuals and entities from knowingly presenting a false or
fraudulent claim or a statement in support of a false or fraudulent claim to
the federal government for payment or approval.
**Liability under the Federal Civil False Claims Act now extends to
subcontractors who submit claims for reimbursement to government
contractors, including Medicare plans.
**The penalties for submitting false claims can be severe; they can include
triple damages and fines.
**Those who submit false or fraudulent claims to the Federal Government,
including Medicare claims, or who participate in such submissions can be
held personally liable for their actions.
**Additionally, individual states may have their own false claims act and
similar penalties (e.g. Florida False Claims Act)
, Examples of False claims - CORRECT ANSWER-**A pharmacy
consistently bills a MA plan for more pills than are actually dispensed to the
plan's enrollees.
**A physician knowingly submits claims for services never provided to
Medicare enrollees.
Federal Anti-Kickback Statute
Example: Billco Pharmacy waives Medicare Part D copayments for certain
drugs to encourage Part D enrollees to fill their Rx's there. - CORRECT
ANSWER-The Federal Anti-Kickback Statute makes it a criminal offense to
knowingly and willfully offer, pay, solicit, or receive any remuneration to
induce or reward referrals of items or services reimbursable by the Federal
Healthcare program, including Medicare.
**Remuneration includes anything of value in cash or in kind. The anti-
kickback regulations do provide safe harbors. If a payment arrangement fits
within these safe harbors it is NOT treated as a violation of the law.
**Penalties: Fines of up to $25,000, imprisonment up to 5 years, or both.
Example of Physician Self-Referral Law (Stark Law) - CORRECT
ANSWER-Dr. Frances Winters refers her patients needing routine blood
tests to an outside independent laboratory that is owned by her husband.
**Penalties for physicians who violate the Stark Law includes fines as well
as exclusion from participation in ALL Federal healthcare programs,
including Medicare.
Civil Monetary Penalties - CORRECT ANSWER-The SS Act (which
governs Medicare) authorizes civil monetary penalties when CMS or other
AND CORRECT ANSWERS 2026
REGISTERED HEALTH INFORMATION
TECHNICIAN STUDY GUIDE AHIMA EXAM
PREP
**A doctor bills Medicare (and falsifies medical records to support the
billing) for services he never provide to Jane Chen. Jane later becomes ill
and is admitted to the hospital. The doctors there rely on her medical
records in making decisions about her condition and her treatment, but
since these records are not accurate, the best medical outcome for Jane may
NOT be achieved.
**Agent Marco Martinez markets MA-PD plans by focusing solely on
premiums--stressing low monthly costs w/o mentioning the potentially
sizable cost sharing obligations that could be faced by a beneficiary. Maria
Sanchez opts for a lower premium policy and later forgoes needed medical
services because of her inability to pay the cost sharing involved in her
policy.
Legal Tools Against FWA (to Combat FWA) - CORRECT ANSWER-There
are several legal tools that the government can employ in its fight against
FWA, including the following statutes:
1. Federal Civil False Claims Act
2. Anti-Kickback Statute
3. Physician Self-Referral Law (Stark Legislation)
4. Criminal Health care Fraud Statute
5. Criminal False Statements Act
6. HIPPA and HITECH Act
,**Violations of these laws can result in non-payment of claims, imposition
of CIVIIL MONETARY PENALTIES, exclusions from the Medicare
program, imprisonment and criminal and civil liability.
The Federal Civil False Claims Act.
Criminal False Statements Act
**The US code provides that anyone who falsifies or conceals a material
fact, makes materially false statements or representations, or uses any false
documents knowing them to contain false statements in any matter within
the jurisdiction of the Executive Branch, which includes CMS, shall be fined
and imprisoned for up to 5 years.
**It would be a violation of this law if independent agents knowingly
provide MA and Part D plans with false information that they know will be
provided to CMS - CORRECT ANSWER-**The federal false claims act
PROHIBITS individuals and entities from knowingly presenting a false or
fraudulent claim or a statement in support of a false or fraudulent claim to
the federal government for payment or approval.
**Liability under the Federal Civil False Claims Act now extends to
subcontractors who submit claims for reimbursement to government
contractors, including Medicare plans.
**The penalties for submitting false claims can be severe; they can include
triple damages and fines.
**Those who submit false or fraudulent claims to the Federal Government,
including Medicare claims, or who participate in such submissions can be
held personally liable for their actions.
**Additionally, individual states may have their own false claims act and
similar penalties (e.g. Florida False Claims Act)
, Examples of False claims - CORRECT ANSWER-**A pharmacy
consistently bills a MA plan for more pills than are actually dispensed to the
plan's enrollees.
**A physician knowingly submits claims for services never provided to
Medicare enrollees.
Federal Anti-Kickback Statute
Example: Billco Pharmacy waives Medicare Part D copayments for certain
drugs to encourage Part D enrollees to fill their Rx's there. - CORRECT
ANSWER-The Federal Anti-Kickback Statute makes it a criminal offense to
knowingly and willfully offer, pay, solicit, or receive any remuneration to
induce or reward referrals of items or services reimbursable by the Federal
Healthcare program, including Medicare.
**Remuneration includes anything of value in cash or in kind. The anti-
kickback regulations do provide safe harbors. If a payment arrangement fits
within these safe harbors it is NOT treated as a violation of the law.
**Penalties: Fines of up to $25,000, imprisonment up to 5 years, or both.
Example of Physician Self-Referral Law (Stark Law) - CORRECT
ANSWER-Dr. Frances Winters refers her patients needing routine blood
tests to an outside independent laboratory that is owned by her husband.
**Penalties for physicians who violate the Stark Law includes fines as well
as exclusion from participation in ALL Federal healthcare programs,
including Medicare.
Civil Monetary Penalties - CORRECT ANSWER-The SS Act (which
governs Medicare) authorizes civil monetary penalties when CMS or other
