AHFI Exam WITH ACCURATE QUESTIONS
AND ANSWERS (VERIFIED ANSWERS) |
LATEST (2026/2027) UPDATED VERSION |
100% GUARANTEED PASS
{JUST RELEASED}
1. Anti-Kickback Statute (42 US SS 1320a-7b (b) prohibitions - ANSWER ✓
Prohibits offering, paying, soliciting or reviving anything of value to induce or
reward referrals or generate Federal health care program business
2. Anti-Kickback Statute (42 US SS 1320a-7b (b) referrals - ANSWER ✓ Referrals
from anyone
3. Anti-Kickback Statute (42 US SS 1320a-7b (b) - ANSWER ✓ Any items or
services
4. Anti-Kickback Statute (42 US SS 1320a-7b (b) (Intent) - ANSWER ✓ Intent
MUST be proven (knowing and willful)
5. Anti-Kickback Statute (42 US SS 1320a-7b (b) Criminal penalties - ANSWER
✓ Fines up to $25,000/violation
Up to a 5-yr prison term/violation
,6. Anti-Kickback Statute (42 US SS 1320a-7b (b) (Civil/administrative) -
ANSWER ✓ False Claims act liability
Civil monetary penalties and program exclusions
Potential $50,000 CMP/violation
Civil assessment of up to 3x amount of kickback
7. Anti-Kickback Statute (42 US SS 1320a-7b (b) Exceptions - ANSWER ✓
Voluntary safe harbors
8. Anti-Kickback Statute (42 US SS 1320a-7b (b) - what it applies to... - ANSWER
✓ All Federal Health Care Programs
9. The Stark Law (42 US SS 139nn) Prohibition - ANSWER ✓ Prohibits a
physician from referring Medicare patients for designated health services to
an entity with which the physician (or immediate family member) has a
financial relationship, unless an exception applies)
Prohibits the designated health services entity from submitting claims to
Medicare for those services resulting from a prohibited referral
10. The Stark Law (42 US SS 139nn) Referrals - ANSWER ✓ Referrals from a
physician
11. The Stark Law (42 US SS 139nn) (Items/Services) - ANSWER ✓ Designated
health services
,12. The Stark Law (42 US SS 139nn) (Intent) - ANSWER ✓ No intent standard for
overpayment (strict liability)
Intent required for civil monetary penalties for knowing violations
13. The Stark Law (42 US SS 139nn) (Civil Penalties) only - ANSWER ✓
Overpayment/refund obligation
False Claims Act liability
Civil monetary penalties and program exclusion for knowing violations
Potential $15,000 CMP for each service
Civil assessment of up to 3x the amount claimed.
14. The Stark Law (42 US SS 139nn) (Exceptions) - ANSWER ✓ Mandatory
exceptions
15. The Stark Law (42 US SS 139nn) applies to - ANSWER ✓ Medicare and
Medicaid
(No commercial or tricare)
16. MACs: - ANSWER ✓ Medicare Administrative Contractors
, They analyze claims to determine provider compliance with Medicare
coverage, coding, and billing rules and take appropriate corrective action
when providers are found to be non-compliant.
17. The goal of Mac administrative actions - ANSWER ✓ To correct the behavior
in need of change and prevent future inappropriate billing
18. The priority of MACs - ANSWER ✓ To minimize potential future losses to the
Medicare Trust Fund through targeted claims review while using resource
efficiently and treating providers and beneficiaries fairly.
19. For repeated infractions, MACs have - ANSWER ✓ The discretion to initiate
progressively more severe administrative action, commensurate with the
seriousness of the identified problem. (See Program Integrity Manual (PIM)
chapter 3, SS3. 7.1)
20. Medicare Fee For Service Recovery Audit Program - ANSWER ✓
Legislative mandated program (Tax Relief and Health Care act of 2006)
Utilizes Recovery Auditors to identify improper payments paid by Medicare to
fee-for-service providers.
Recovery Auditors identify improper payments
MACs adjust the claims, recoup identified overpayment and return
underpayment.s.
AND ANSWERS (VERIFIED ANSWERS) |
LATEST (2026/2027) UPDATED VERSION |
100% GUARANTEED PASS
{JUST RELEASED}
1. Anti-Kickback Statute (42 US SS 1320a-7b (b) prohibitions - ANSWER ✓
Prohibits offering, paying, soliciting or reviving anything of value to induce or
reward referrals or generate Federal health care program business
2. Anti-Kickback Statute (42 US SS 1320a-7b (b) referrals - ANSWER ✓ Referrals
from anyone
3. Anti-Kickback Statute (42 US SS 1320a-7b (b) - ANSWER ✓ Any items or
services
4. Anti-Kickback Statute (42 US SS 1320a-7b (b) (Intent) - ANSWER ✓ Intent
MUST be proven (knowing and willful)
5. Anti-Kickback Statute (42 US SS 1320a-7b (b) Criminal penalties - ANSWER
✓ Fines up to $25,000/violation
Up to a 5-yr prison term/violation
,6. Anti-Kickback Statute (42 US SS 1320a-7b (b) (Civil/administrative) -
ANSWER ✓ False Claims act liability
Civil monetary penalties and program exclusions
Potential $50,000 CMP/violation
Civil assessment of up to 3x amount of kickback
7. Anti-Kickback Statute (42 US SS 1320a-7b (b) Exceptions - ANSWER ✓
Voluntary safe harbors
8. Anti-Kickback Statute (42 US SS 1320a-7b (b) - what it applies to... - ANSWER
✓ All Federal Health Care Programs
9. The Stark Law (42 US SS 139nn) Prohibition - ANSWER ✓ Prohibits a
physician from referring Medicare patients for designated health services to
an entity with which the physician (or immediate family member) has a
financial relationship, unless an exception applies)
Prohibits the designated health services entity from submitting claims to
Medicare for those services resulting from a prohibited referral
10. The Stark Law (42 US SS 139nn) Referrals - ANSWER ✓ Referrals from a
physician
11. The Stark Law (42 US SS 139nn) (Items/Services) - ANSWER ✓ Designated
health services
,12. The Stark Law (42 US SS 139nn) (Intent) - ANSWER ✓ No intent standard for
overpayment (strict liability)
Intent required for civil monetary penalties for knowing violations
13. The Stark Law (42 US SS 139nn) (Civil Penalties) only - ANSWER ✓
Overpayment/refund obligation
False Claims Act liability
Civil monetary penalties and program exclusion for knowing violations
Potential $15,000 CMP for each service
Civil assessment of up to 3x the amount claimed.
14. The Stark Law (42 US SS 139nn) (Exceptions) - ANSWER ✓ Mandatory
exceptions
15. The Stark Law (42 US SS 139nn) applies to - ANSWER ✓ Medicare and
Medicaid
(No commercial or tricare)
16. MACs: - ANSWER ✓ Medicare Administrative Contractors
, They analyze claims to determine provider compliance with Medicare
coverage, coding, and billing rules and take appropriate corrective action
when providers are found to be non-compliant.
17. The goal of Mac administrative actions - ANSWER ✓ To correct the behavior
in need of change and prevent future inappropriate billing
18. The priority of MACs - ANSWER ✓ To minimize potential future losses to the
Medicare Trust Fund through targeted claims review while using resource
efficiently and treating providers and beneficiaries fairly.
19. For repeated infractions, MACs have - ANSWER ✓ The discretion to initiate
progressively more severe administrative action, commensurate with the
seriousness of the identified problem. (See Program Integrity Manual (PIM)
chapter 3, SS3. 7.1)
20. Medicare Fee For Service Recovery Audit Program - ANSWER ✓
Legislative mandated program (Tax Relief and Health Care act of 2006)
Utilizes Recovery Auditors to identify improper payments paid by Medicare to
fee-for-service providers.
Recovery Auditors identify improper payments
MACs adjust the claims, recoup identified overpayment and return
underpayment.s.
