AHIP Fraud Waste and Abuse Questions With VerifiedANSWERs

AHIP Fraud Waste and Abuse Questions With VerifiedANSWERs You are performing a regular inventory of the controlled substances in the pharmacy. You discover a minor inventory discrepancy. What should you do? - ANSWER Follow your pharmacy's procedures Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper Management only. - ANSWER False Ways to report a compliance issue include: - ANSWER All of the above What is the policy of non-retaliation? - ANSWER Protects employees who, in good faith, report suspected non-compliance These are examples of issues that can be reported to a Compliance Department: suspected Fraud, Waste, and Abuse (FWA); potential health privacy violation, and unethical behavior/employee misconduct. - ANSWER True Once a corrective action plan begins addressing non-compliance or Fraud, Waste, and Abuse (FWA) committed by a Sponsor's employee or First-Tier, Downstream, or Related Entity's (FDR's) employee, ongoing monitoring of the corrective actions is not necessary. - ANSWER False Medicare Parts C and D plan Sponsors are not required to have a compliance program. - ANSWER False At a minimum, an effective compliance program includes four core requirements. - ANSWER False Standards of Conduct are the same for every Medicare Parts C and D Sponsor. - ANSWER False Correcting non-compliance ______________. - ANSWER Protects enrollees, avoids recurrence of the same non- compliance, and promotes efficienc What are some of the consequences for non-compliance, fraudulent, or unethical behavior? - ANSWER All of the above ACA Section 1557 differs from earlier legislation in providing broader protection against discrimination based on - ANSWER sex Section 1557 of the Affordable Care Act applies to - ANSWER c. all health programs and activities administered by or receiving federal financial assistance from HHS. Correct Which Medicare programs are covered by ACA Section 1557? - ANSWER a. Parts A, C, and D, but not B. Correct Under ACA Section 1557, prohibited actions involve - ANSWER d. eligibility, claims, and marketing. Correct Under ACA Section 1557, a person - ANSWER c. cannot be discriminated against based on her legal or illegal immigration status or ability to speak English. Correct Under ACA Section 1557, a health plan - ANSWER d. cannot deny coverage to LEP individuals and is required to provide language assistance to them, free of charge. Correct