AHIP 2024 FRAUD Final Exam QUESTIONS AND ANSWERS 100% 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. - ANSWERTrue Once a corrective action plan is started, the corrective action plan must be monitored annually to ensure they are effective. - ANSWERFalse These are examples of issues that should be reported to a Compliance Department: suspected fraud, waste, and abuse (FWA); potential health privacy violation, unethical behavior, and employee misconduct. - ANSWERTrue What are some of the penalties for violating fraud, waste, and abuse (FWA) laws? - ANSWERAll of the above Some of the laws governing Medicare Part C and D fraud, waste, and abuse (FWA) include the Health Insurance Portability and Accountability Act (HIPAA), the Civil False Claims Act, the Anti-Kickback Statute, and the Criminal Health Care Fraud Statute. - ANSWERTrue 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. - ANSWERFalse Ways to report potential fraud, waste, and abuse (FWA) include: - ANSWERAll of the above You can help prevent fraud, waste, and abuse (FWA) by doing all the following: Look for suspicious activity Conduct yourself in an ethical manner Ensure accurate and timely data and billing Ensure you coordinate with other payers