CPMA EXAM FINAL PAPER 2026 FULL
QUESTIONS AND ACCURATE ANSWERS
GRADED A+
⩥ CERT and Postpayment Review Process: If there is an error on the
claim. Answer: This does not apply to CERT, although CERT will accept
additional documentation and signature attestations, signature logs, and
electronic signature protocols received prior to the deadline for the
annual report.
⩥ The 3 types of business relationships that may raise fraud and abuse
concerns. Answer: Relationships with payers
Relationships with fellow physicians & other providers
Relationships with vendors
⩥ Federal fraud and abuse laws that apply to physicians include all of
the following. Answer: False Claims Act (FCA)
Anti-Kickback Statute (AKS)
Physician Self-Referral Law (Stark Law)
Social Security Act
United State Criminal Code
,⩥ Violating Federal fraud and abuse laws may result in. Answer:
nonpayment of claims, Civil Monetary Penalties (CMPs), exclusion
from all Federal healthcare programs (including Medicare), and criminal
and civil liability.
⩥ What agencies enforce the laws against Federal fraud and abuse.
Answer: Government agencies, including the U.S. Department of Justice
(DOJ), the U.S. Department of Health & Human Services (HHS), the
HHS Office of Inspector General (OIG), and the Centers for Medicare &
Medicaid Services (CMS).
⩥ The Federal False Claims Act (FCA) protects. Answer: the Federal
Government from being overcharged or sold substandard goods or
services.
⩥ The Federal False Claims Act (FCA) imposes. Answer: civil liability
on any person who KNOWINGLY submits or CAUSES the submission
of, a false or fraudulent claim to the Federal Government.
The terms "knowing" and "knowingly" mean a person has actual
knowledge of the information or acts in deliberate ignorance or reckless
disregard of the truth, or falsity of the information
⩥ No proof of specific intent to defraud is required to violate the Civil.
Answer: False Claims Act (FCA)
, ⩥ An example of violating the False Claims Act (FCA) may be a.
Answer: a physician who knowingly submits claims to Medicare for
medical services not provided.
⩥ Civil penalties for violations of the False Claims Act (FCA), occurring
on or after 11.25.2015, may include. Answer: fines of up to 3x the
amount of damages sustained by the Government as a result of the false
claims + up to $21,563 per false claim filed.
⩥ Under the Federal criminal statutes, criminal penalties for submitting
false claims may include. Answer: fines, imprisonment, or both.
⩥ The Anti-Kickback Statute (AKS). Answer: makes it a crime 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.
⩥ Remuneration includes. Answer: anything of value, such as cash, free
rent, expensive hotel stays and meals, and excessive compensation for
medical directorships or consultancies.
⩥ Civil penalties for violating the AKS may include. Answer: penalties
of up to $50,000 per kickback + 3x the amount of kickback.
QUESTIONS AND ACCURATE ANSWERS
GRADED A+
⩥ CERT and Postpayment Review Process: If there is an error on the
claim. Answer: This does not apply to CERT, although CERT will accept
additional documentation and signature attestations, signature logs, and
electronic signature protocols received prior to the deadline for the
annual report.
⩥ The 3 types of business relationships that may raise fraud and abuse
concerns. Answer: Relationships with payers
Relationships with fellow physicians & other providers
Relationships with vendors
⩥ Federal fraud and abuse laws that apply to physicians include all of
the following. Answer: False Claims Act (FCA)
Anti-Kickback Statute (AKS)
Physician Self-Referral Law (Stark Law)
Social Security Act
United State Criminal Code
,⩥ Violating Federal fraud and abuse laws may result in. Answer:
nonpayment of claims, Civil Monetary Penalties (CMPs), exclusion
from all Federal healthcare programs (including Medicare), and criminal
and civil liability.
⩥ What agencies enforce the laws against Federal fraud and abuse.
Answer: Government agencies, including the U.S. Department of Justice
(DOJ), the U.S. Department of Health & Human Services (HHS), the
HHS Office of Inspector General (OIG), and the Centers for Medicare &
Medicaid Services (CMS).
⩥ The Federal False Claims Act (FCA) protects. Answer: the Federal
Government from being overcharged or sold substandard goods or
services.
⩥ The Federal False Claims Act (FCA) imposes. Answer: civil liability
on any person who KNOWINGLY submits or CAUSES the submission
of, a false or fraudulent claim to the Federal Government.
The terms "knowing" and "knowingly" mean a person has actual
knowledge of the information or acts in deliberate ignorance or reckless
disregard of the truth, or falsity of the information
⩥ No proof of specific intent to defraud is required to violate the Civil.
Answer: False Claims Act (FCA)
, ⩥ An example of violating the False Claims Act (FCA) may be a.
Answer: a physician who knowingly submits claims to Medicare for
medical services not provided.
⩥ Civil penalties for violations of the False Claims Act (FCA), occurring
on or after 11.25.2015, may include. Answer: fines of up to 3x the
amount of damages sustained by the Government as a result of the false
claims + up to $21,563 per false claim filed.
⩥ Under the Federal criminal statutes, criminal penalties for submitting
false claims may include. Answer: fines, imprisonment, or both.
⩥ The Anti-Kickback Statute (AKS). Answer: makes it a crime 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.
⩥ Remuneration includes. Answer: anything of value, such as cash, free
rent, expensive hotel stays and meals, and excessive compensation for
medical directorships or consultancies.
⩥ Civil penalties for violating the AKS may include. Answer: penalties
of up to $50,000 per kickback + 3x the amount of kickback.
