Fraud Certification Evaluation Verified Questions With Complete Solutions

FRAUD CERTIFICATION EVALUATION
VERIFIED QUESTIONS WITH COMPLETE
SOLUTIONS

●● false
Answer: Once a corrective action plan is started, the corrective actions
must be monitored annually to ensure they are effective.
:
True False


●● false
Answer: Any person who knowingly submits false claims to the
Government is liable for five times the Government's damages caused
by the violator plus a penalty.
:
True False


●● true
Answer: These are examples of issues that should be reported to a
Compliance Department: suspected Fraud, Waste, and Abuse (FWA);
potential health privacy violation, and unethical behavior/employee
misconduct.
:
True False

,●● true
Answer: Bribes or kickbacks of any kind for services that are paid under
a Federal health care program (which includes Medicare) constitute
fraud by the person making as well as the person receiving them.
:
True False


●● true
Answer: Waste includes any misuse of resources such as the overuse of
services, or other practices that, directly or indirectly, result in
unnecessary costs to the Medicare Program.
:
True False


●● ACA Section 1557 differs from earlier legislation in providing
broader protection against discrimination based on
Answer: sex


●● Section 1557 of the Affordable Care Act applies to
Answer: c. all health programs and activities administered by or
receiving federal financial assistance from HHS. Correct


●● Which Medicare programs are covered by ACA Section 1557?

,Answer: a. Parts A, C, and D, but not B. Correct


●● Under ACA Section 1557, prohibited actions involve
Answer: d. eligibility, claims, and marketing. Correct


●● Under ACA Section 1557, a person
Answer: c. cannot be discriminated against based on her legal or illegal
immigration status or ability to speak English. Correct


●● Under ACA Section 1557, a health plan
Answer: d. cannot deny coverage to LEP individuals and is required to
provide language assistance to them, free of charge. Correct


●● Which of these actions is most likely to be permitted in dealing with
a person with limited English proficiency?
Answer: a. Allowing a child to interpret in an emergency. Correct


●● Under ACA Section 1557, sex discrimination includes a person's
Answer: c. sex, pregnancy, sex stereotypes, or gender identity. Correct


●● Under ACA Section 1557, a health plan sold through a state
exchange may, based on an individual's age,
Answer: d. charge higher premiums. Correct

, ●● ACA Section 1557 rules for disability concern
Answer: d. Policies and procedures, physical access, and
communication. Correct


●● Which area of potential discrimination is not generally covered by
ACA Section 1557?
Answer: c. Employment (with the exception of the provision of health
insurance). Correct


●● As a result of violations of ACA Section 1557 nondiscrimination
rules,
Answer: c. a health plan may revoke an agent or broker's appointment
with the health plan. Correct


●● For a health plan, what are the possible consequences of violations of
ACA Section 1557?
Answer: b. Loss of federal business and compensatory damages. Correct


●● If a health plan violates ACA Section 1557 nondiscrimination
protections, it may be
Answer: c. required to take corrective action and sometimes pay
damages, and it may be sued by individuals. Correct