CDEO Chapter 3 exam with correct
answers
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Documentation |states |that |the |patient |had |a |"Status |post |hysterectomy. |The |patient |presents |with |a |
fever." |Which |of |the |following |would |be |a |compliant |question |to |query? |- |VERIFIED |ANSWER✔✔-Do |
you |know |the |cause |of |the |fever?
Operation |Restore |Trust |- |VERIFIED |ANSWER✔✔-3 |offices |were |involved: |OIG, |Healthcare |Financing |
Administration, |AoA
May |1995 |Bill |Clinton: |2 |yr |partnership |of |federal |and |state |agencies, |working |together |to |protect |the
|healthcare |trust |funds |through |shared |intelligence |coordinated |enforcement, |intended |to |enhance |
quality |of |care |for |program's |beneficiaries. |
Program |is |not |called |Senior |Medicare |Patrol |SMP
They |work |to |combat |fraud |and |abuse.
SMP |- |VERIFIED |ANSWER✔✔-Senior |Medicare |Patrol
OIG |- |VERIFIED |ANSWER✔✔-Office |of |Inspector |General
AoA |- |VERIFIED |ANSWER✔✔-Administration |on |Aging
FCA |- |VERIFIED |ANSWER✔✔-False |Claims |Act
CMPL |- |VERIFIED |ANSWER✔✔-Civil |Money |Penalties |Law
CMS |Definition |of |Fraud |- |VERIFIED |ANSWER✔✔-knowingly |making |false |statements |or |
misrepresenting |facts |to |obtain |an |undeserved |benefit |or |payment |from |a |federal |healthcare |program
CMS |Definition |of |Abuse |- |VERIFIED |ANSWER✔✔-an |action |resulting |in |unnecessary |costs |to |a |federal
|healthcare |program |either |directly |or |indirectly
CMS |Examples |of |Fraud |- |VERIFIED |ANSWER✔✔-Billing |for |Services/Supplies |that |you |know |were |not |
furnished |or |provided |
Altering |claim |forms |and/or |receipts |to |receive |a |higher |payment |amount |
, Billing |for |services |at |a |level |higher |than |provided |or |necessary
Misrepresenting |the |diagnosis |to |justify |payment
Making |referrals |to |certain |designated |services |that |are |prohibited
CMS |Examples |of |Abuse |- |VERIFIED |ANSWER✔✔-Misusing |codes |on |claims
Charging |excessively |for |service |or |supplies
Billing |for |services |that |were |not |medically |necessary
Failure |to |maintain |adequate |medical |or |financial |records
Improper |billing |practices
Billing |Medicare |patients |a |higher |fee |schedule |than |non-medicare |patients
FCA |- |VERIFIED |ANSWER✔✔-Federal |
False |Claims |Act
Lincoln |Law |- |VERIFIED |ANSWER✔✔-False |Claims |Act, |enacted |1863 |to |combat |fraud |from |suppliers |
of |good |to |the |Union |Army |during |the |Civil |War
In |1943 |amendments |made |it |more |difficult |to |bring |action |forward.
In |1986 |Congress |enacted |an |overhaul |that |generated |new |fraud |investigations |and |actions.
The |Statute |is |in |title |31, |subtitle |III, |CH. |37, |subchapter |III, |of |the |US |code |31 |U.S.C. |3729(a).1
Title |31 |Statute's |7 |Types |of |Conduct |- |VERIFIED |ANSWER✔✔-that |brings |liability |FCA
answers
Save
Documentation |states |that |the |patient |had |a |"Status |post |hysterectomy. |The |patient |presents |with |a |
fever." |Which |of |the |following |would |be |a |compliant |question |to |query? |- |VERIFIED |ANSWER✔✔-Do |
you |know |the |cause |of |the |fever?
Operation |Restore |Trust |- |VERIFIED |ANSWER✔✔-3 |offices |were |involved: |OIG, |Healthcare |Financing |
Administration, |AoA
May |1995 |Bill |Clinton: |2 |yr |partnership |of |federal |and |state |agencies, |working |together |to |protect |the
|healthcare |trust |funds |through |shared |intelligence |coordinated |enforcement, |intended |to |enhance |
quality |of |care |for |program's |beneficiaries. |
Program |is |not |called |Senior |Medicare |Patrol |SMP
They |work |to |combat |fraud |and |abuse.
SMP |- |VERIFIED |ANSWER✔✔-Senior |Medicare |Patrol
OIG |- |VERIFIED |ANSWER✔✔-Office |of |Inspector |General
AoA |- |VERIFIED |ANSWER✔✔-Administration |on |Aging
FCA |- |VERIFIED |ANSWER✔✔-False |Claims |Act
CMPL |- |VERIFIED |ANSWER✔✔-Civil |Money |Penalties |Law
CMS |Definition |of |Fraud |- |VERIFIED |ANSWER✔✔-knowingly |making |false |statements |or |
misrepresenting |facts |to |obtain |an |undeserved |benefit |or |payment |from |a |federal |healthcare |program
CMS |Definition |of |Abuse |- |VERIFIED |ANSWER✔✔-an |action |resulting |in |unnecessary |costs |to |a |federal
|healthcare |program |either |directly |or |indirectly
CMS |Examples |of |Fraud |- |VERIFIED |ANSWER✔✔-Billing |for |Services/Supplies |that |you |know |were |not |
furnished |or |provided |
Altering |claim |forms |and/or |receipts |to |receive |a |higher |payment |amount |
, Billing |for |services |at |a |level |higher |than |provided |or |necessary
Misrepresenting |the |diagnosis |to |justify |payment
Making |referrals |to |certain |designated |services |that |are |prohibited
CMS |Examples |of |Abuse |- |VERIFIED |ANSWER✔✔-Misusing |codes |on |claims
Charging |excessively |for |service |or |supplies
Billing |for |services |that |were |not |medically |necessary
Failure |to |maintain |adequate |medical |or |financial |records
Improper |billing |practices
Billing |Medicare |patients |a |higher |fee |schedule |than |non-medicare |patients
FCA |- |VERIFIED |ANSWER✔✔-Federal |
False |Claims |Act
Lincoln |Law |- |VERIFIED |ANSWER✔✔-False |Claims |Act, |enacted |1863 |to |combat |fraud |from |suppliers |
of |good |to |the |Union |Army |during |the |Civil |War
In |1943 |amendments |made |it |more |difficult |to |bring |action |forward.
In |1986 |Congress |enacted |an |overhaul |that |generated |new |fraud |investigations |and |actions.
The |Statute |is |in |title |31, |subtitle |III, |CH. |37, |subchapter |III, |of |the |US |code |31 |U.S.C. |3729(a).1
Title |31 |Statute's |7 |Types |of |Conduct |- |VERIFIED |ANSWER✔✔-that |brings |liability |FCA
