CPCO chapter 4 -4/5 Exam 2025
Questions and Answers
If a group pays a hospital monthly rent for office space that is one-half the going rate or
fair market value, this is a violation of which regulation?
Stark Law
FCA
CMS guidelines
Anti-Kickback Statute - ....ANSWER ...-Anti-Kickback Statute
Examples of anti-kickback statute violations:• A hospital providing rental rates below
fair market value to a physician who refers business to the hospital• Routine waiver of
copayments or deductibles for patients under Medicare Part B• A drug or equipment
supplier providing free benefits to a provider who utilizes their product• A physician who
is paid exorbitantly for speaking engagements by a company to whom the provider refers
business
The RICO Act is a law that increases the severity of penalties for violations of what?
HIPAA
Human resources
Organized crime
Improper claim submissions - ....ANSWER ...-Organized crime
…FOR STUDENTS ONLY…©️2025 ALL RIGHTS RESERVED… 1
,The RICO Act is a law that increases the severity of penalties for violations involving
organized crime.
Deficit Reduction Act (DRA) requires that providers who have more than $5 million
either received or paid to the reimbursement from state Medicaid programs inform
employees of their ability to__________?
Bring a whistleblower action
File paper claims
E-prescribe medications to reduce errors
Self-disclose overpayments within 90 days - ....ANSWER ...-Bring a whistleblower
action
DRA also requires that providers who have more than $5 million dollars either received
or paid to the reimbursement from state Medicaid programs to provide training and
educate employees on the FCA and inform employees of their ability to bring a
whistleblower action.
The BBA of 1997 created an alternate sanction allowing the government to levy a civil
fine of up to how much for each violation of the Anti-Kickback Statute?
$20,000, and an assessment of three times the amount of the kickback
$50,000, and an assessment of three times the amount of the kickback
$75,000, and an assessment of three times the amount of the kickback
$100,000, and an assessment of three times the amount of the kickback -
....ANSWER ...-$50,000, and an assessment of three times the amount of the
kickback
…FOR STUDENTS ONLY…©️2025 ALL RIGHTS RESERVED… 2
, The government may levy a civil fine of up to $50,000 for each violation of the Anti-
Kickback Statute, and an assessment of three times the amount of the kickback.
Under what circumstances can a relator not file or pursue a qui tam action?
If they are a new employee
The qui tam action is based upon information that has been disclosed to the public
The government already is a party to a civil or administrative money proceeding
Both b and c - ....ANSWER ...-Both b and c
The FCA provides several circumstances when a relator cannot file or pursue a qui tam
action:1 - The relator was convicted of criminal conduct arising from his or her role in
the FCA violation2 - Another qui tam concerning the same conduct already has been
filed (this is known as the "first to file bar")3 - The government already is a party to a
civil or administrative money proceeding concerning the same conduct4 - The qui tam
action is based upon information that has been disclosed to the public through any of
several means: criminal, civil, or administrative hearings in which the government is a
party, government hearings, audits, reports, or investigations, or through the news media
(this is known as the "public disclosure bar"). There is an exception to the public
disclosure bar where the relator was the original source of the information.
Which of the following represents a violation of the Stark Law?
the referring physician, or an immediate member of the referring physician's family, has
a financial relationship with the entity receiving the referral.
the referring physician's best friend from medical school owns the entity receiving the
referral.
the referring physician's neighbor owns the entity receiving the referral.
…FOR STUDENTS ONLY…©️2025 ALL RIGHTS RESERVED… 3
Questions and Answers
If a group pays a hospital monthly rent for office space that is one-half the going rate or
fair market value, this is a violation of which regulation?
Stark Law
FCA
CMS guidelines
Anti-Kickback Statute - ....ANSWER ...-Anti-Kickback Statute
Examples of anti-kickback statute violations:• A hospital providing rental rates below
fair market value to a physician who refers business to the hospital• Routine waiver of
copayments or deductibles for patients under Medicare Part B• A drug or equipment
supplier providing free benefits to a provider who utilizes their product• A physician who
is paid exorbitantly for speaking engagements by a company to whom the provider refers
business
The RICO Act is a law that increases the severity of penalties for violations of what?
HIPAA
Human resources
Organized crime
Improper claim submissions - ....ANSWER ...-Organized crime
…FOR STUDENTS ONLY…©️2025 ALL RIGHTS RESERVED… 1
,The RICO Act is a law that increases the severity of penalties for violations involving
organized crime.
Deficit Reduction Act (DRA) requires that providers who have more than $5 million
either received or paid to the reimbursement from state Medicaid programs inform
employees of their ability to__________?
Bring a whistleblower action
File paper claims
E-prescribe medications to reduce errors
Self-disclose overpayments within 90 days - ....ANSWER ...-Bring a whistleblower
action
DRA also requires that providers who have more than $5 million dollars either received
or paid to the reimbursement from state Medicaid programs to provide training and
educate employees on the FCA and inform employees of their ability to bring a
whistleblower action.
The BBA of 1997 created an alternate sanction allowing the government to levy a civil
fine of up to how much for each violation of the Anti-Kickback Statute?
$20,000, and an assessment of three times the amount of the kickback
$50,000, and an assessment of three times the amount of the kickback
$75,000, and an assessment of three times the amount of the kickback
$100,000, and an assessment of three times the amount of the kickback -
....ANSWER ...-$50,000, and an assessment of three times the amount of the
kickback
…FOR STUDENTS ONLY…©️2025 ALL RIGHTS RESERVED… 2
, The government may levy a civil fine of up to $50,000 for each violation of the Anti-
Kickback Statute, and an assessment of three times the amount of the kickback.
Under what circumstances can a relator not file or pursue a qui tam action?
If they are a new employee
The qui tam action is based upon information that has been disclosed to the public
The government already is a party to a civil or administrative money proceeding
Both b and c - ....ANSWER ...-Both b and c
The FCA provides several circumstances when a relator cannot file or pursue a qui tam
action:1 - The relator was convicted of criminal conduct arising from his or her role in
the FCA violation2 - Another qui tam concerning the same conduct already has been
filed (this is known as the "first to file bar")3 - The government already is a party to a
civil or administrative money proceeding concerning the same conduct4 - The qui tam
action is based upon information that has been disclosed to the public through any of
several means: criminal, civil, or administrative hearings in which the government is a
party, government hearings, audits, reports, or investigations, or through the news media
(this is known as the "public disclosure bar"). There is an exception to the public
disclosure bar where the relator was the original source of the information.
Which of the following represents a violation of the Stark Law?
the referring physician, or an immediate member of the referring physician's family, has
a financial relationship with the entity receiving the referral.
the referring physician's best friend from medical school owns the entity receiving the
referral.
the referring physician's neighbor owns the entity receiving the referral.
…FOR STUDENTS ONLY…©️2025 ALL RIGHTS RESERVED… 3
