Cpma Exam Questions And Answers
A provider consistently charges a higher level E/M service than is documented to help cover the
cost of his declining practice. Would this be fraud or abuse Why?
a. Abuse,charging one level higher on each visits does not show intent.
b. Abuse; the provider's practice is common and therefore would not be considered fraudulent .
c. Fraud; and over-coding of services would be considered fraudulent.
d. Fraud; the provider intentionally over-coded to gain financially. d. Fraud; the provider
intentionally over-coded to gain financially.
The OIG lists potential risk areas for individual and small physician groups in the compliance
plan guidance. Which option below is listed as a risk area?
a. Unbundling
b. Under Coding
, Cpma Exam Questions And Answers
c. Overuse of E/M codes
d. Failure to follow the "same day" rule a. Unbundling
The FCA allows for reduced penalties if the person in violation self-discloses if which conditions
exist?
a. The person furnishes all information about the violation with in 30 days after which the
defendant first obtained the information.
b. The person fully cooperates with the investigation.
c. There is no additional criminal prosecution, civil action, or administrated action with the
respect to the violation.
d. All of the above d. All of the above
What is a Qui Tam Relator?
, Cpma Exam Questions And Answers
a. a person who is prosecuted under FCA.
b. The defendant in a Stark Law case.
c. a person listed on the OIG exclusions list.
d. a person who brings civil action for violation under the FCA for themselves and the
government. d. a person who brings civil action for violation under the FCA for
themselves and the government.
What is CoP?
a. Medicare Conditions of Participation.
b. TriCare's Compliance of Physicians Guidance
c. Medicaid's Coordination of Physician Groups
d. Commercial Programs a. Medicare Conditions of Participation.
When a provider is excluded under the Exclusions statute, What must he or she do at the end of
the exclusionary period?
, Cpma Exam Questions And Answers
a. the provider is automatically reinstated
b. The provider must apply for reinstatement.
c. The provider cannot be reinstated once excluded.
d. The provider must apply for a group provider number. b. The provider must apply for
reinstatement
Which option is considered a material breach of CIA?
a. Failure to engage and use an IRO in accordance with the CIA.
b. Failure to hire an OIG employee to oversee compliance efforts.
c. Failure to hire a full-time internal auditor to review every claim before it is submitted.
A provider consistently charges a higher level E/M service than is documented to help cover the
cost of his declining practice. Would this be fraud or abuse Why?
a. Abuse,charging one level higher on each visits does not show intent.
b. Abuse; the provider's practice is common and therefore would not be considered fraudulent .
c. Fraud; and over-coding of services would be considered fraudulent.
d. Fraud; the provider intentionally over-coded to gain financially. d. Fraud; the provider
intentionally over-coded to gain financially.
The OIG lists potential risk areas for individual and small physician groups in the compliance
plan guidance. Which option below is listed as a risk area?
a. Unbundling
b. Under Coding
, Cpma Exam Questions And Answers
c. Overuse of E/M codes
d. Failure to follow the "same day" rule a. Unbundling
The FCA allows for reduced penalties if the person in violation self-discloses if which conditions
exist?
a. The person furnishes all information about the violation with in 30 days after which the
defendant first obtained the information.
b. The person fully cooperates with the investigation.
c. There is no additional criminal prosecution, civil action, or administrated action with the
respect to the violation.
d. All of the above d. All of the above
What is a Qui Tam Relator?
, Cpma Exam Questions And Answers
a. a person who is prosecuted under FCA.
b. The defendant in a Stark Law case.
c. a person listed on the OIG exclusions list.
d. a person who brings civil action for violation under the FCA for themselves and the
government. d. a person who brings civil action for violation under the FCA for
themselves and the government.
What is CoP?
a. Medicare Conditions of Participation.
b. TriCare's Compliance of Physicians Guidance
c. Medicaid's Coordination of Physician Groups
d. Commercial Programs a. Medicare Conditions of Participation.
When a provider is excluded under the Exclusions statute, What must he or she do at the end of
the exclusionary period?
, Cpma Exam Questions And Answers
a. the provider is automatically reinstated
b. The provider must apply for reinstatement.
c. The provider cannot be reinstated once excluded.
d. The provider must apply for a group provider number. b. The provider must apply for
reinstatement
Which option is considered a material breach of CIA?
a. Failure to engage and use an IRO in accordance with the CIA.
b. Failure to hire an OIG employee to oversee compliance efforts.
c. Failure to hire a full-time internal auditor to review every claim before it is submitted.
