Fraud abuse regulations Study guides, Class notes & Summaries

WGU C426 Healthcare Values and Ethics Rated A+ Normative Ethics Attempt to determine what moral standards should be followed so that human behavior and conduct may be morally right. Consequential Ethics Theory of ethics emphasizes that the morally right action is whatever action leads to the maximum balance of good over evil. - What will be the effects of each course of action? - Will they be positive or negative? - Who will benefit? - What will do the least harm? Utilitarian Ethics The conce...

LATEST 2023 HESI COMPREHENSIVE REVIEW (NCLEX RN) EXAM 5TH ED QUESTIONS & ANSWERS WITH EXPLANATIONS (GUARANTEED A++) HESI Comprehensive Review for the NCLEX-RN® Examination FIFTH EDITION Editor E. Tina Cuellar, PhD, WHNP, PMHCNS, BC Director of Curriculum, Review and Testing, Elsevier/HESI, Houston, Texas Table of Contents Cover image Title page Copyright Contributing Authors Reviewers Preface 1. Introduction to Testing and the NCLEX-RN® Examination Test-Taking Tips The NCL...

AHIP TRAINING Medicare Fraud, Waste, and Abuse Training EXAM 50+ QUESTIONS AND VERIFIED CORRECT ANSWERS 2023. AHIP TRAINING Medicare Fraud, Waste, and Abuse Training 1. Medicare plan means: A MA plan, MA-PD plan or PDP 2. Subcontractor means: **An individual or entity that provides services on behalf of a Medicare plan sponsor. This includes individuals and organizations with DIRECT relationship with the plan sponsor or individuals or organizations with INDIRECT relationship, such as ...

True or False: The ACA requires that all providers adopt a compliance plan as a condition of enrollment with Medicare, Medicaid, and Children's Health Insurance Program (CHIP). - Answer- True ref. ACA section 6102 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - Answer- 1.Protect our programs 2.Protect your patients 3.Protect the Provider At which level of the Medicare Part A or Part B appeals process is the app...

FITSP-MANAGER EXAM QUESTIONS AND ANSWERS this legislation requires Federal agencies to develop document and implement an agency wide information security program - Answer ️️ -Clinger-Cohen What are the six steps of the RMF - Answer ️️ -Categorize Select Implement Assess Authorize Monitor What is the term used to evaluate operational information systems against the RMF, to determine the security controls in place and the requirements to mitigate risk at a acceptable level? - An...

What is defined as any felonious act of corruption or attempt to cheat the Government or corrupt the Government's agents by charge card program officials? - Correct answerInternal Fraud If transactions not made by the Cardholder appear on the Statement of Account, the Cardholder should dispute them with the card-issuing bank within how many days of the transaction date? - Correct answer-90 Which of the following is an agreement that is not binding solely because the Government representat...

2023 United HealthCare - Ethics and Compliance 1. In terms of events, which of the following is true? 2. When completing an enrollment application in LEAN, why is an agent prohibited from entering their own email address in a field available for the consumer's email address? 3. Annual Election Period (AEP) is a time when 4. You have scheduled an appointment and obtained a Scope of Appointment (SOA) form to discuss Medicare Advantage Plans with a consumer. When you arrive at the app...

CLG 0010 Exam, Questions With Answers/ 100% Correct.1. What is defined as any felonious act of corruption or attempt to cheat the Government or corrupt the Government's agents by charge card program officials? Internal Fraud 2. If transactions not made by the Cardholder appear on the Statement of Account, the Cardholder should dispute them with the card-issuing bank within how many days of the transaction date? 90 3. Which of the following is an agreement that is not binding solely becau...

What are Medical Ethics? - Answer-Standards of conduct based on moral principle. they are generally accepted as a guide for behavior towards pt's, dr's, coworkers, the gov, and ins co's What does acting within ethical behavior boundaries mean? - Answer-Carrying out one's responsibilities with integrity, dignity, respect, honesty, competence, fairness, and trust Compliance regulations - Answer-Most billing-related cases are based on HIPAA and False Claims Act Health Insurance Portabi...

CHC (2023/ 2024) Exam V1 |150 Questions and Verified Answers| 100% Correct Q: This is a very comprehensive legislation that ensures access to health coverage for those who change jobs or are temporarily out of work. It also provides the mechanism for funding the Department of Justice and the FBI for health care fraud investigations Answer: Health Insurance Portability and Accountability (HIPAA) Q: How long is PHI protected after the person's death? Answer: 50 years ...

What are the Federal Agencies that are part of the U.S. Department of Health and Human Services (HHS)? - ANSWER Centers of Medicare & Medicaid Services (CMS) Office of Inspector General (OIG) What are the HHS Operating Divisions? - ANSWER National Institutes of Health (NIH) Food and Drug Administration (FDA) Centers of Disease Control and Prevention (CDC) Agency for Toxic Substances and Disease Registry (ATSDR) Indian Health Service (HIS) Health Resources and Services Administration (SA...

CLG 0010 Exam 100% Scored_ Spring 2023 1. What is defined as any felonious act of corruption or attempt to cheat the Government or corrupt the Government's agents by charge card program officials? 2. If transactions not made by the Cardholder appear on the Statement of Account, the Cardholder should dispute them with the card-issuing bank within how many days of the transaction date? 3. Which of the following is an agreement that is not binding solely because the Government representa...