AHIP

Ways to report potential Fraud, Waste, and Abuse (FWA) include: a. Telephone hotlines b. Mail Drops c. In-person reporting to the compliance department/supervisor d. Special Investigations Units (SIUs) e. All of the above e Once a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective. : True False false Any person who knowingly submits false claims to the Government is liable for five times the Government's damages c...

How to recognize FWA in the Medicare Program Knowledge of the law including the Civil False claims Act, Health Care Fraud Statute, and Criminal Fraud, Anti-Kickback Statute, Stark Statute, Exclusion from all Federal healthcare programs, and the Health Insurance Portability and Accountability Act. Civil False Claims Act Makes a person liable to pay damages to the government if 1. He or she knowingly conspires to commit FWA. 2. Carries out other acts to obtain property from the government ...

Ways to report potential Fraud, Waste, and Abuse (FWA) include: a. Telephone hotlines b. Mail Drops c. In-person reporting to the compliance department/supervisor d. Special Investigations Units (SIUs) e. All of the above e Once a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective. : True False false Any person who knowingly submits false claims to the Government is liable for five times the Government's damages c...

Once a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective. False Ways to report potential fraud, waste, and abuse (FWA) include: All of the above Any person who knowingly submits false claims to the government is liable for five times the government's damages caused by the violator plus a penalty. False These are examples of issues that should be reported to a compliance department: suspected fraud, waste, and abuse (FWA...

Once a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective. False Ways to report potential fraud, waste, and abuse (FWA) include: All of the above Any person who knowingly submits false claims to the government is liable for five times the government's damages caused by the violator plus a penalty. False These are examples of issues that should be reported to a compliance department: suspected fraud, waste, and abuse (FWA...

Bribes or kickbacks of any kind for services that are paid under a Federal healthcare program (which includes Medicare) constitute fraud by the person making as well as the person receiving them. True Once a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective. False Any person who knowingly submits false claims to the Government is liable for five times the Government's damages caused by the violator plus a penalty. False ...

Medicare plan means A MA plan, MA-PD plan or PDP Subcontractor means **An individual or entity that provides services on behalf of a Medicare plan sponsor. This includes individuals and organizations with DIRECT relationship with the plan sponsor or individuals or organizations with INDIRECT relationship, such as an agent who has a contract with an agency or filed marketing organization that contract with a Medicare plan. FWA Training: A compliance program component **ALL Medicare plan...

Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? Fraud Which of the following is NOT potentially a penalty for violation of a law or regulation prohibiting Fraud, Waste, and Abuse (FWA)? Deportation A person comes to your pharmacy to drop off a prescription for a beneficiary who is a "regular" customer. The prescription is for a controlled substance with a quantity of 160. This beneficiary normally receives a quantity of 60, not 1...

Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? Fraud Which of the following is NOT potentially a penalty for violation of a law or regulation prohibiting Fraud, Waste, and Abuse (FWA)? Deportation A person comes to your pharmacy to drop off a prescription for a beneficiary who is a "regular" customer. The prescription is for a controlled substance with a quantity of 160. This beneficiary normally receives a quantity of 60, not 1...

Under ACA Section 1557, a health plan sold through a state exchange may, based on an individual's age, Limit benefits and services. Under ACA Section 1557, a health plan Cannot deny coverage to LEP individuals and is required to provide language assistance to them, free of charge. ACA Section 1557 rules for disability concern Policies and procedures, physical access, and communication. Which of the following statements best describes Section 1557 of the Affordable Care Act (ACA)? S...