Cpma Study Questions And Answers
What is the civil penalty Not less than 5000 and not more than 10,000 per claim x3 times
the amount of government damages
Federal False Claims Act Having knowledge that claims is fake.
.1 knowing and knowingly that a person must act in deliberate ignorance of the truth or falsely of
the relevant information or act in a reckless manner of the truth or falsity of the Information
Qui Tam whistleblower
what percentage is offered for a whistleblower/qui tam as an award from what is recovered by
the government? between 15% and 25%
fraud Knowingly making false statements or misrepresenting facts to obtain an
undeserved benefit or payment from federal healthcare program
Discovery sample CIA - 50 samples units randomly selected *determines the net financial
error rate .2 if error rate exceeds 5% a full sample must be reviewed
, Cpma Study Questions And Answers
HHS OIG 3 core publications 1.work plan
2.semiannual report to congress
3. compendium unimplemented recommendation
non-compliant conduct must be documented in compliance files & should include 1. date
of incident
2.name of the reporting party
3.name of the person responsible for taking action
4.the follow up the action taken
What is an auditor Reviews healthcare providers policies add procedures to ensure
compliance with applicable requirements
cms uses what avenues to deliver Information 1.webcasts
2. transmitting
3.manuals
4.the medicare learning network
What is the civil penalty Not less than 5000 and not more than 10,000 per claim x3 times
the amount of government damages
Federal False Claims Act Having knowledge that claims is fake.
.1 knowing and knowingly that a person must act in deliberate ignorance of the truth or falsely of
the relevant information or act in a reckless manner of the truth or falsity of the Information
Qui Tam whistleblower
what percentage is offered for a whistleblower/qui tam as an award from what is recovered by
the government? between 15% and 25%
fraud Knowingly making false statements or misrepresenting facts to obtain an
undeserved benefit or payment from federal healthcare program
Discovery sample CIA - 50 samples units randomly selected *determines the net financial
error rate .2 if error rate exceeds 5% a full sample must be reviewed
, Cpma Study Questions And Answers
HHS OIG 3 core publications 1.work plan
2.semiannual report to congress
3. compendium unimplemented recommendation
non-compliant conduct must be documented in compliance files & should include 1. date
of incident
2.name of the reporting party
3.name of the person responsible for taking action
4.the follow up the action taken
What is an auditor Reviews healthcare providers policies add procedures to ensure
compliance with applicable requirements
cms uses what avenues to deliver Information 1.webcasts
2. transmitting
3.manuals
4.the medicare learning network
