AHIP 2026 - MEDICARE FRAUD, WASTE, &
ABUSE FINAL EXAM 2026 WITH 100%
ACCURATE ANSWERS
1. What is the definition of abuse in the context of Medicare fraud, waste,
and abuse?
Providing unnecessary services to patients.
Payment for items or services when there is no legal
entitlement to that payment.
Billing for services not rendered.
Deliberate misrepresentation of facts to obtain payment.
2. Which of the following is NOT an example of an issue that should be
reported to a Compliance Department?
Suspected fraud, waste, and abuse (FWA)
Potential health privacy violation
Unethical behavior
Routine administrative errors
3. Makes it a criminal offense to knowingly and willfully offer, pay, solicit,
or receive any remuneration directly or indirectly to induce or reward
referrals of items or services reimbursable by a Federal health care
program. Which type of Medicare fraud is listed?
Phantom Billing
Patient billing
Anti-kickback
Upcoding/unbundling
Stark Law
, 4. Why is it important to conduct oneself in an ethical manner in relation to
Medicare FWA?
Ethical conduct is only necessary for management, not for all
staff.
Ethical behavior does not impact FWA.
Ethics are less important than meeting financial targets.
Conducting oneself ethically helps to maintain integrity and
trust in healthcare practices, reducing the risk of FWA.
5. Which of the following fully describes penalties for convicted
employees?
Imprisonment (which may include a life term for violations
resulting in death)
Fines, imprisonment, and exclusion from federal health care
programs
No fines or imprisonment because individuals are not held
responsible for violations committed while transacting business
for an employer
Fines amounting to thousands of dollars and exclusion from
federal health care programs
6. What happens after a corrective action plan is developed?
The company should determine exactly who or what caused the
problem in the first place.
The company should forward the document to the appropriate
government agency.
The company should monitor progress on the steps developed
in the action plan.
The company should forward the document to the company
ABUSE FINAL EXAM 2026 WITH 100%
ACCURATE ANSWERS
1. What is the definition of abuse in the context of Medicare fraud, waste,
and abuse?
Providing unnecessary services to patients.
Payment for items or services when there is no legal
entitlement to that payment.
Billing for services not rendered.
Deliberate misrepresentation of facts to obtain payment.
2. Which of the following is NOT an example of an issue that should be
reported to a Compliance Department?
Suspected fraud, waste, and abuse (FWA)
Potential health privacy violation
Unethical behavior
Routine administrative errors
3. Makes it a criminal offense to knowingly and willfully offer, pay, solicit,
or receive any remuneration directly or indirectly to induce or reward
referrals of items or services reimbursable by a Federal health care
program. Which type of Medicare fraud is listed?
Phantom Billing
Patient billing
Anti-kickback
Upcoding/unbundling
Stark Law
, 4. Why is it important to conduct oneself in an ethical manner in relation to
Medicare FWA?
Ethical conduct is only necessary for management, not for all
staff.
Ethical behavior does not impact FWA.
Ethics are less important than meeting financial targets.
Conducting oneself ethically helps to maintain integrity and
trust in healthcare practices, reducing the risk of FWA.
5. Which of the following fully describes penalties for convicted
employees?
Imprisonment (which may include a life term for violations
resulting in death)
Fines, imprisonment, and exclusion from federal health care
programs
No fines or imprisonment because individuals are not held
responsible for violations committed while transacting business
for an employer
Fines amounting to thousands of dollars and exclusion from
federal health care programs
6. What happens after a corrective action plan is developed?
The company should determine exactly who or what caused the
problem in the first place.
The company should forward the document to the appropriate
government agency.
The company should monitor progress on the steps developed
in the action plan.
The company should forward the document to the company
