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CPCO chapter 4 - 3/4 Questions and Verified
Answers
If a group pays a hospital monthly rent for office space that is one-half the going
rate or fair market value, this is a violation of which regulation?
Stark Law
FCA
CMS guidelines
Anti-Kickback Statute
Ans: Anti-Kickback Statute
Examples of anti-kickback statute violations:• A hospital providing rental
rates below fair market value to a physician who refers business to the
hospital• Routine waiver of copayments or deductibles for patients under
Medicare Part B• A drug or equipment supplier providing free benefits to a
provider who utilizes their product• A physician who is paid exorbitantly for
speaking engagements by a company to whom the provider refers business
The RICO Act is a law that increases the severity of penalties for violations of
what?
HIPAA
Human resources
Organized crime
Improper claim submissions
Ans: Organized crime
The RICO Act is a law that increases the severity of penalties for violations
involving organized crime.
Deficit Reduction Act (DRA) requires that providers who have more than $5
million either received or paid to the reimbursement from state Medicaid
programs inform employees of their ability to__________?
Bring a whistleblower action
File paper claims
E-prescribe medications to reduce errors
Self-disclose overpayments within 90 days
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Ans: Bring a whistleblower action
DRA also requires that providers who have more than $5 million dollars
either received or paid to the reimbursement from state Medicaid programs
to provide training and educate employees on the FCA and inform employees
of their ability to bring a whistleblower action.
The BBA of 1997 created an alternate sanction allowing the government to levy a
civil fine of up to how much for each violation of the Anti-Kickback Statute?
$20,000, and an assessment of three times the amount of the kickback
$50,000, and an assessment of three times the amount of the kickback
$75,000, and an assessment of three times the amount of the kickback
$100,000, and an assessment of three times the amount of the kickback
Ans: $50,000, and an assessment of three times the amount of the
kickback
The government may levy a civil fine of up to $50,000 for each violation of
the Anti-Kickback Statute, and an assessment of three times the amount of
the kickback.
Under what circumstances can a relator not file or pursue a qui tam action?
If they are a new employee
The qui tam action is based upon information that has been disclosed to the
public
The government already is a party to a civil or administrative money proceeding
Both b and c
Ans: Both b and c
The FCA provides several circumstances when a relator cannot file or
pursue a qui tam action:1 - The relator was convicted of criminal conduct
arising from his or her role in the FCA violation2 - Another qui tam
concerning the same conduct already has been filed (this is known as the
"first to file bar")3 - The government already is a party to a civil or
administrative money proceeding concerning the same conduct4 - The qui
tam action is based upon information that has been disclosed to the public
through any of several means: criminal, civil, or administrative hearings in
which the government is a party, government hearings, audits, reports, or
investigations, or through the news media (this is known as the "public
disclosure bar"). There is an exception to the public disclosure bar where the
relator was the original source of the information.
Which of the following represents a violation of the Stark Law?
CPCO chapter 4 - 3/4 Questions and Verified
Answers
If a group pays a hospital monthly rent for office space that is one-half the going
rate or fair market value, this is a violation of which regulation?
Stark Law
FCA
CMS guidelines
Anti-Kickback Statute
Ans: Anti-Kickback Statute
Examples of anti-kickback statute violations:• A hospital providing rental
rates below fair market value to a physician who refers business to the
hospital• Routine waiver of copayments or deductibles for patients under
Medicare Part B• A drug or equipment supplier providing free benefits to a
provider who utilizes their product• A physician who is paid exorbitantly for
speaking engagements by a company to whom the provider refers business
The RICO Act is a law that increases the severity of penalties for violations of
what?
HIPAA
Human resources
Organized crime
Improper claim submissions
Ans: Organized crime
The RICO Act is a law that increases the severity of penalties for violations
involving organized crime.
Deficit Reduction Act (DRA) requires that providers who have more than $5
million either received or paid to the reimbursement from state Medicaid
programs inform employees of their ability to__________?
Bring a whistleblower action
File paper claims
E-prescribe medications to reduce errors
Self-disclose overpayments within 90 days
, Page | 2
Ans: Bring a whistleblower action
DRA also requires that providers who have more than $5 million dollars
either received or paid to the reimbursement from state Medicaid programs
to provide training and educate employees on the FCA and inform employees
of their ability to bring a whistleblower action.
The BBA of 1997 created an alternate sanction allowing the government to levy a
civil fine of up to how much for each violation of the Anti-Kickback Statute?
$20,000, and an assessment of three times the amount of the kickback
$50,000, and an assessment of three times the amount of the kickback
$75,000, and an assessment of three times the amount of the kickback
$100,000, and an assessment of three times the amount of the kickback
Ans: $50,000, and an assessment of three times the amount of the
kickback
The government may levy a civil fine of up to $50,000 for each violation of
the Anti-Kickback Statute, and an assessment of three times the amount of
the kickback.
Under what circumstances can a relator not file or pursue a qui tam action?
If they are a new employee
The qui tam action is based upon information that has been disclosed to the
public
The government already is a party to a civil or administrative money proceeding
Both b and c
Ans: Both b and c
The FCA provides several circumstances when a relator cannot file or
pursue a qui tam action:1 - The relator was convicted of criminal conduct
arising from his or her role in the FCA violation2 - Another qui tam
concerning the same conduct already has been filed (this is known as the
"first to file bar")3 - The government already is a party to a civil or
administrative money proceeding concerning the same conduct4 - The qui
tam action is based upon information that has been disclosed to the public
through any of several means: criminal, civil, or administrative hearings in
which the government is a party, government hearings, audits, reports, or
investigations, or through the news media (this is known as the "public
disclosure bar"). There is an exception to the public disclosure bar where the
relator was the original source of the information.
Which of the following represents a violation of the Stark Law?
