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Exam (elaborations)

COMBATING MEDICARE PARTS C AND D FRAUD, WASTE, AND ABUSE WITH 100% CORRECT ANSWERS

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Once a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective. O True O False False Ways to report fraud, waste, and abuse (FWA) include: A. Telephone hotlines B. Mail drops C. In-person reporting to the compliance department/supervisor D. Special Investigations Units (SIUs) E. All of the above E. All of the above 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. O True O False False 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. O True O False True Bribes or kickbacks of any kind for services that are paid under a Federal healthcare program (which includes Medicare) constitute fraud by the person making as well as the person receiving them. O True O False True Waste indicates 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. O True O False True Abuse involves payment for items or services when there is no legal entitlement to that payment and the provider has not knowingly and/or intentionally misrepresented facts to obtain payment. O True O False True Some of the laws governing Medicare Parts C and D Fraud, Waste, and Abuse (FWA) include the Health Insurance Portability and Accountability Act (HIPAA); the False Claim Act; the Anti-Kickback Statute; the List of Excluded Individuals and Entities (LEIE); and the Health Care Fraud Statute. O True O False True You can help prevent fraud, waste, and abuse (FWA) by doing all of the following:Look for suspicious activityConduct yourself in an ethical mannerEnsure accurate and timely data/billingEnsure you coordinate with you payersKeep up to date with FWA policies and procedures, standards of conduct, and Medicare & Medicaid Services (CMS) guidanceVerify all information provided to you O True O False True

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Medicare+ Fraud, Waste, And Abuse 2024
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Medicare+ Fraud, Waste, and Abuse 2024








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Medicare+ Fraud, Waste, and Abuse 2024
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Medicare+ Fraud, Waste, and Abuse 2024

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Uploaded on
November 30, 2023
Number of pages
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Written in
2023/2024
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