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regulations which apply to any claim for an item or service that was not
provided as claimed or that was knowingly submitted as false and which
provides guidelines for levying of fines for such offenses.
A. Health Insurance Portability and Accountability Act (HIPAA)
B. Civil Monetary Penalties Law
C. Anti - Kickback Law
D. Exclusion Staute - ✔✔B. Civil Monetary Penalties Law
The affirmation by signature, usually on a printed form, that the action outlined
has been accomplished by the individual signing; e.g., the individual has read
the code of conduct and agreed to adhere to its principles.
A. Treatment
B. Attestation
C. Self - Reporting
D. Safe - Harbors - ✔✔B. Attestation
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,the provision, coordination, or management of health care and related services
by one or more health care providers,
A. Benchmarking
B. Disclosure
C. Attestation
D. Treatment - ✔✔D. treatment
Omnibus Budget Reconciliation Act of 1989 (OBRA) bans physicians from
referring 10 designated health care services to any entity with which physician
has a financial relationship.
A. Health Insurance Portability and Accountability Act (HIPAA)
B. Self - referral statute, Stark Law
C. Corporate Integrity Agreement (CIA)
D. False Claims Act (FCA) - ✔✔B. Self - referral statute, Stark Law
Explicit regulatory exceptions to otherwise legally prohibited conduct. Federal
safe harbor regulations specify certain joint ventures and other arrangements
concerning hospitals and/or physicians which do not violate medicare fraud and
abuse laws.
A. Attestation
B. Health Care Clearinghouse
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, C. Health Care Provider
D. Safe Harbors - ✔✔D. Safe Harbors
A coder who has satisfied certification requirements as established by the
American Academy of Professional Coders
A. Health Care Operations pt 6
B. Certified Professional Coder (CPC)
C. Federal Sentencing Guidelines
D. Equal Employee Opportunity Commission (EEOC) - ✔✔B. Certified
Professional Coder (CPC)
Healthcare Fraud Prevention and Enforcement Action Team
A. HEAT
B. HHS
C. Health Care
D. Treatment - ✔✔A. HEAT
employees, volunteers, trainees, etc who conduct in the performance of work
for the covered entity
A. Benchmarking
B. Best practices
C. Workforce
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