Fraud, Waste, Abuse - 2, Fraud Waste and Abuse, Preventing Fraud, Abuse & Waste, Fraud, Abuse, and Waste, Fraud Waste and Abuse 2024 AHIP, fraud, waste, and abuse prevention| 100% Correct

Fraud, Waste, Abuse - 2, Fraud Waste and Abuse, Preventing Fraud, Abuse & Waste, Fraud, Abuse, and Waste, Fraud Waste and Abuse 2024 AHIP, fraud, waste, and abuse prevention| 100% Correct e - Answer ️️ -Ways to report potential 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 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 Ways to report potential Fraud, Waste, and Abuse (FWA) include: - Answer ️️ -e. All of the above Correct Once a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective. - Answer ️️ -False 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. - Answer ️️ -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. - Answer ️️ -True 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. - Answer ️️ -True Correct 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. - Answer ️️ -True You can help prevent Fraud, Waste, and Abuse (FWA) by doing all of the following: • Look for suspicious activity; • Conduct yourself in an ethical manner; • Ensure accurate and timely data/billing; • Ensure you coordinate with other payers; • Keep up to date with FWA policies and procedures, standards of conduct, laws, regulations, and the Centers for Medicare & Medicaid Services (CMS) guidance; and • Verify all information provided to you. - Answer ️️ -F What are some of the penalties for violating Fraud, Waste, and Abuse (FWA) laws? - Answer ️️ -all of the above