Fraud, Waste, and Abuse

1.

Multiple Choice

1 min

1 pt

Once a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective.

True

False

2.

Multiple Choice

1 min

1 pt

Ways to prevent potential fraud, waste, and abuse (FWA) include:

Telephone hotlines

Mail drops

In-person reporting to the compliance department/supervisor

Special Investigation Units (SIUs)

All of the above

3.

Multiple Choice

1 min

1 pt

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.

True

False

4.

Multiple Choice

1 min

1 pt

These are examples of issues that should be reported to a Compliance Department: suspected fraud, waste, and abuse (FWA); potential health privacy violation; unethical behavior; and employee misconduct.

True

False

5.

Multiple Choice

1 min

1 pt

Bribes or kickbacks of any kind for services that are paid under a Federal health care program (which includes Medicare) constitute fraud by the person making as well as the person receiving them.

True

False

6.

Multiple Choice

1 min

1 pt

Waste includes any misuse of resources, such as the overuse of services or other practices that, directly or indirectly, result in unnecessary costs to the Medicare Program.

True

False

7.

Multiple Choice

1 min

1 pt

Abuse involves payment for items or services when there is no legal entitlement to that payment and the provider has not knowingly or intentionally misrepresented facts to obtain payment.

True

False

8.

Multiple Choice

1 min

1 pt

Some of the laws governing Medicare Parts C and D fraud, waste, and abuse (FWA) include the Health Insurance Portability and Accountability Act (HIPAA), the False Claims Act, the Anti-Kickback Statute, and the Health Care Fraud Statute.

True

False

9.

Multiple Choice

1 min

1 pt

You can help prevent fraud, waste, and abuse (FWA) by doing all of the following: look for suspicious activity; conduct yourself in an ethical manner; ensure accurate and timely data and billing; ensure you coordinate with other payers; verify all information provided to you; and keep up to date with FWA policies and procedures, standards of conduct, laws, regulations, and the Centers for Medicare and Medicaid Services (CMS) guidance.

True

False

10.

Multiple Choice

1 min

1 pt

What are some of the penalties for violating fraud, waste, and abuse (FWA) laws?

Civil Monetary Penalties

Imprisonment

Exclusion from participation in all Federal health care programs

All of the above

Explore this activity with a free account