AHIP 2025 FRAUD FINAL EXAM
Waste includes any misuse of resources, such as the overuse of services or other practices that
directly or indirectly result in unnecessary
costs to the Medicare Program. - answers✔✔True
Once a corrective action plan is started, the corrective action plan must be monitored annually
to ensure they are effective. - answers✔✔False
These are examples of issues that should be reported to a Compliance Department: suspected
fraud, waste, and abuse (FWA); potential
health privacy violation, unethical behavior, and employee misconduct. - answers✔✔True
What are some of the penalties for violating fraud, waste, and abuse (FWA) laws? -
answers✔✔All of the above
Some of the laws governing Medicare Part C and D fraud, waste, and abuse (FWA) include the
Health Insurance Portability and
Accountability Act (HIPAA), the Civil False Claims Act, the Anti-Kickback Statute, and the Criminal
Health Care Fraud Statute. - answers✔✔True
Any person who knowingly submits false claims to the Government is liable for five times the
Government's damages caused by the
violator plus a penalty. - answers✔✔False
Ways to report potential fraud, waste, and abuse (FWA) include: - answers✔✔All of the above
Waste includes any misuse of resources, such as the overuse of services or other practices that
directly or indirectly result in unnecessary
costs to the Medicare Program. - answers✔✔True
Once a corrective action plan is started, the corrective action plan must be monitored annually
to ensure they are effective. - answers✔✔False
These are examples of issues that should be reported to a Compliance Department: suspected
fraud, waste, and abuse (FWA); potential
health privacy violation, unethical behavior, and employee misconduct. - answers✔✔True
What are some of the penalties for violating fraud, waste, and abuse (FWA) laws? -
answers✔✔All of the above
Some of the laws governing Medicare Part C and D fraud, waste, and abuse (FWA) include the
Health Insurance Portability and
Accountability Act (HIPAA), the Civil False Claims Act, the Anti-Kickback Statute, and the Criminal
Health Care Fraud Statute. - answers✔✔True
Any person who knowingly submits false claims to the Government is liable for five times the
Government's damages caused by the
violator plus a penalty. - answers✔✔False
Ways to report potential fraud, waste, and abuse (FWA) include: - answers✔✔All of the above
