CPB STUDY GUIDE EXAMS SET COMPLETE
QUESTIONS AND ANSWERS 2026 VIEW
AHEAD TEST.
⫸ Anti-kickback. Ans: Knowingly and willfully offering or
accepting rewards or remuneration for services that are billable to a
federal healthcare plan.
⫸ Benefiiciary. Ans: An individual that is eligible for Medicare or
Medicaid benefits based on the CMS guidelines.
⫸ Conditions of Participation (CoP). Ans: Conditions that healthcare
organizations must meet in order to participate with the plan or
program.
⫸ Covered Entity. Ans: Clearinghouse and providers who
electronically transmit any health information in connection with
transactions for which HHS has adopted standards.
⫸ Criminal Healthcare Fraud Act. Ans: Scheme to willingly defraud
any healthcare benefit program.
⫸ False Claims Act. Ans: Federal statute setting criminal and civil
penalties for falsely billing the government; over representing the
amount of a delivered product, or under stating an obligation to the
government.
, ⫸ Fraud. Ans: Making false statements or misrepresenting facts to
obtain an undeserved benefit or payment from a federal HC program.
⫸ HIPAA-Health Insurance Portability and Accountability Act of
1996. Ans: Federal law in which the primary goal is to make it easier
for people to keep insurance, protect the confidentiality and security
of HC info and help control administration costs.
⫸ PPO-Preferred Provider Organization. Ans: Managed care
organization of Drs, hospitals and other providers who agree with
insurer to provide HC at reduced rates to their clients.
⫸ PHI-Protected Health informaion. Ans: Individually identifiable
health information, reasonably used to identify an individual.
⫸ Qui Tam Action. Ans: A lawsuit brought by a private citizen
against a person or company who is believed to have violated the law
in the performance contact with the government of in violation of
government regulation.
⫸ Stark Law. Ans: A federal law that places limitations of certain
physician referrals.
⫸ Truth in Lending Act. Ans: An act which requires lenders to
inform borrowers of all direct, indirect and true costs of credit.
QUESTIONS AND ANSWERS 2026 VIEW
AHEAD TEST.
⫸ Anti-kickback. Ans: Knowingly and willfully offering or
accepting rewards or remuneration for services that are billable to a
federal healthcare plan.
⫸ Benefiiciary. Ans: An individual that is eligible for Medicare or
Medicaid benefits based on the CMS guidelines.
⫸ Conditions of Participation (CoP). Ans: Conditions that healthcare
organizations must meet in order to participate with the plan or
program.
⫸ Covered Entity. Ans: Clearinghouse and providers who
electronically transmit any health information in connection with
transactions for which HHS has adopted standards.
⫸ Criminal Healthcare Fraud Act. Ans: Scheme to willingly defraud
any healthcare benefit program.
⫸ False Claims Act. Ans: Federal statute setting criminal and civil
penalties for falsely billing the government; over representing the
amount of a delivered product, or under stating an obligation to the
government.
, ⫸ Fraud. Ans: Making false statements or misrepresenting facts to
obtain an undeserved benefit or payment from a federal HC program.
⫸ HIPAA-Health Insurance Portability and Accountability Act of
1996. Ans: Federal law in which the primary goal is to make it easier
for people to keep insurance, protect the confidentiality and security
of HC info and help control administration costs.
⫸ PPO-Preferred Provider Organization. Ans: Managed care
organization of Drs, hospitals and other providers who agree with
insurer to provide HC at reduced rates to their clients.
⫸ PHI-Protected Health informaion. Ans: Individually identifiable
health information, reasonably used to identify an individual.
⫸ Qui Tam Action. Ans: A lawsuit brought by a private citizen
against a person or company who is believed to have violated the law
in the performance contact with the government of in violation of
government regulation.
⫸ Stark Law. Ans: A federal law that places limitations of certain
physician referrals.
⫸ Truth in Lending Act. Ans: An act which requires lenders to
inform borrowers of all direct, indirect and true costs of credit.
