AHIP FRAUD WASTE AND ABUSE EXAM LATEST 2025 WITH
CORRECT QUESTIONS AND DETAILED ANSWERS/ALREADY
GRADED A+
e - CORRECT 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 - CORRECT ANSWER-Once a corrective action plan is started, the
corrective actions must be monitored annually to ensure they are effective.
:
True False
,false - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER-sex
Section 1557 of the Affordable Care Act applies to - CORRECT 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? - CORRECT
ANSWER-a. Parts A, C, and D, but not B. Correct
Under ACA Section 1557, prohibited actions involve - CORRECT ANSWER-d.
eligibility, claims, and marketing. Correct
Under ACA Section 1557, a person - CORRECT 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 - CORRECT 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? - CORRECT ANSWER-a. Allowing a child to interpret
in an emergency. Correct
CORRECT QUESTIONS AND DETAILED ANSWERS/ALREADY
GRADED A+
e - CORRECT 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 - CORRECT ANSWER-Once a corrective action plan is started, the
corrective actions must be monitored annually to ensure they are effective.
:
True False
,false - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER-sex
Section 1557 of the Affordable Care Act applies to - CORRECT 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? - CORRECT
ANSWER-a. Parts A, C, and D, but not B. Correct
Under ACA Section 1557, prohibited actions involve - CORRECT ANSWER-d.
eligibility, claims, and marketing. Correct
Under ACA Section 1557, a person - CORRECT 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 - CORRECT 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? - CORRECT ANSWER-a. Allowing a child to interpret
in an emergency. Correct
