CDEO EXAM PREP 2025-2026 COMPLETE EXAM TEST
QUESTIONS AND VERIFIED ANSWERS (MULTIPLE CHOICES )
VERIFIED 100% GRADED A+
Section 3729a.I.G
It provides liability where a person acts improperly to
Reverse False Claims Section
avoid paying money owed to the government.
Requires the knowledge that it is false to be fraud.
Defines the terms Knowing and Knowingly such that a
person must act in deliberate ignorance of the truth or
falsity of the relevant information, or acts in reckless
Section 3729b.1. disregard of the truth or falsity of the information;
however, the act states that a violation may occur even
if there no intent to defraud
The FCA is not violated merely by submitting a false
claim, but rather by submitting or causing to be
submitted a false claim with the knowledge that it is
false.
originally provided for a civil penalty of $5,000 and not
Title 31 Statute
more than $10,000 per claim plus 3x the amount of
government damage if FCA liability was found
Federal Civil Penalties Inflation Adjustment Act
Current penalties $10,781 to $21,563 per claim. also
FCPIA
liable for the costs of the civil action brought to recover
any such penalties or damages
Also contains a criminal statute that can result in criminal
penalties.
FCA allows for reduced penalties (mitigation) if the
Self Disclosing Violation
person committing the violation come forward
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states a court may assess not less than 2x the amount of
3729.a.2
damages the government sustains because of the act
of the person
A) the person responsible furnishes officials of the US
responsible for investigating false claims violations
Self Disclosing 37.29.a.2
with all information known to such a person about
the
violation within 30 days after the date of which the
defendant first obtained the information;
B) Such person fully cooperates with the investigation of such
violation, and
Self Disclosing 37.29.a.2 C) at the time such person furnishes the information
about the violation, no criminal prosecution, civil action,
or administrative action has commenced under this title
with respect to the violation, and the person did not
had actual knowledge of the existence of an
investigation into such a violation
1. Falsifying a medical chart notation
2. Submitting a cliams for services not performed, not requested,
or unnecessary
31 U.S.C 3729 (a) 1 Examples 3. Submitting claims for expired drugs
4. Upcoding and/or unbundling services
5. Submitting claims for physician services performed
by a non-physician provider NPP without regard to
incident-to-guidelines
Qui Tam : 3730 ss describes the civil actions for false claims. This is where this
provision is described
is an abbreviation from the latin "qui tam pro domino
rege quam pro sic ipso in hoc parte sequitur"
meaning who as well for the king as for himself sues in this
matter
Qui Tam
Qui Tam actions were first used in 13th Center England,
by citizens wishing to gain access to the king's court. The
complainant received a monetary reward, called a
"bounty" for bringing lawbreakers to justice. Because
the US founding fathers
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retained English common law, Qui Tam was incorporated
into many early American statutes.
initiated and confirmed on November 22, 2010, when the
Department of Justice
Qui Tam released a statment on the record $2.5 billion health
care fraud recoveries for fiscal year 2010. Of the $ total,
in civil settlement and judgments for cases involving
fraud against the government, over 2.3 billion was
recovered in lawsuits filed under the FCA Qui Tam
provisions.
the FCA refers to the person bringing the Qui Tam as a
Qui Tam
relator, in the field the relator is more commonly
referred to as a "whistleblower"
NPP Non Physician Provider
Stark Law
Physician Self-Referral Law
Bans Referrals to entities for a DHS
DHS Designated Health Services
Clinical Laboratory
Services Physical
Therapy Services
Occupational Therapy
Services Radiology
Designated Health Services Services
Radiation Services
DME Equipment and Supplies
Parenteral and enteral nutrients, equipment,
and supplies Prosthetic and orthotic
devices and supplies
Home Health Services
Outpatient Prescription Drugs
Inpatient and outpatient hospital services
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