CDEO Chapter 3 Questions and Answers 100% verified

Operation Restore Trust - ANSWER-3 offices were involved: OIG, Healthcare Financing Administration, AoA May 1995 Bill Clinton: 2 yr partnership of federal and state agencies, working together to protect the healthcare trust funds through shared intelligence coordinated enforcement, intended to enhance quality of care for program's beneficiaries. Program is not called Senior Medicare Patrol SMP They work to combat fraud and abuse. SMP - ANSWER-Senior Medicare Patrol OIG - ANSWER-Office of Inspector General AoA - ANSWER-Administration on Aging FCA - ANSWER-False Claims Act CMPL - ANSWER-Civil Money Penalties Law CMS Definition of Fraud - ANSWER-knowingly making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Definition of Abuse - ANSWER-an action resulting in unnecessary costs to a federal healthcare program either directly or indirectly CMS Examples of Fraud - ANSWER-Billing for Services/Supplies that you know were not furnished or provided Altering claim forms and/or receipts to receive a higher payment amount