CIC Exam Prep - Chapter 12 Compliance
in the Facility Exam 2026 Questions and
Answers
The federal ___________ law prohibits anyone (a person or corporate entity) from
intentionally soliciting or receiving remuneration (anything of value such as bribes,
rebates, Cash, etc.), directly or indirectly, to get Patient referrals and/or additional
business reimbursed under federal healthcare Programs Such as Medicare and
Medicaid. - Correct answer-anti-kickback
The purpose of the anti-kickback rule is to protect patients and federal healthcare
programs from _________ and _______ . - Correct answer-fraud and abuse
The ___________ Law governs physician self-referral for Medicare and Medicaid
patients. Also known as the "physician self-Referral law,'' this statute prohibits
physicians from referring patients to medical facilities in which the physician or a
member of the Physician's immediate family has a financial interest, Whether by
ownership, investment, or a Compensation arrangement. It includes services billed
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, by hospitals but provided by a Physician-Owned entity under contract with the
hospital. - Correct answer-Stark
The Recovery Audit Contractor (RAC) program was created through the Medicare
Modernization Act of 2003 (MMA) to identify and _________ improper Medicare
payments paid to healthcare providers under fee-for-Service (FFS) Medicare Plans.
The RAC program began as a Medicare demonstration Program. - Correct answer-
recover
RACs employ two types of audit processes: __________ and ________. - Correct
answer-automated and complex
An _________ audit focuses on easily detectable payment errors. Given the ease of
detectability, the automated process requires no human review or medical records
to determine a finding of improper payment. - Correct answer-automated
The ___________ audit targets improper payments that cannot be determined
based on a simple review, requiring manual evaluation of medical records and
supporting documentation to determine a finding. - Correct answer-complex
Currently, the RACs are held to a _____ -year look back period for the
identification of improper payments. - Correct answer-3
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in the Facility Exam 2026 Questions and
Answers
The federal ___________ law prohibits anyone (a person or corporate entity) from
intentionally soliciting or receiving remuneration (anything of value such as bribes,
rebates, Cash, etc.), directly or indirectly, to get Patient referrals and/or additional
business reimbursed under federal healthcare Programs Such as Medicare and
Medicaid. - Correct answer-anti-kickback
The purpose of the anti-kickback rule is to protect patients and federal healthcare
programs from _________ and _______ . - Correct answer-fraud and abuse
The ___________ Law governs physician self-referral for Medicare and Medicaid
patients. Also known as the "physician self-Referral law,'' this statute prohibits
physicians from referring patients to medical facilities in which the physician or a
member of the Physician's immediate family has a financial interest, Whether by
ownership, investment, or a Compensation arrangement. It includes services billed
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
, by hospitals but provided by a Physician-Owned entity under contract with the
hospital. - Correct answer-Stark
The Recovery Audit Contractor (RAC) program was created through the Medicare
Modernization Act of 2003 (MMA) to identify and _________ improper Medicare
payments paid to healthcare providers under fee-for-Service (FFS) Medicare Plans.
The RAC program began as a Medicare demonstration Program. - Correct answer-
recover
RACs employ two types of audit processes: __________ and ________. - Correct
answer-automated and complex
An _________ audit focuses on easily detectable payment errors. Given the ease of
detectability, the automated process requires no human review or medical records
to determine a finding of improper payment. - Correct answer-automated
The ___________ audit targets improper payments that cannot be determined
based on a simple review, requiring manual evaluation of medical records and
supporting documentation to determine a finding. - Correct answer-complex
Currently, the RACs are held to a _____ -year look back period for the
identification of improper payments. - Correct answer-3
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
