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

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    Fraud, Waste, and Abuse

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    Professional Development

    Professional Development

    Professional Development Fraud, Waste, and Abuse

    Joe Kelly Johnson 218 plays

    10 Qs

    Show Answers See Preview 1. Multiple-choice 1 minute 5 pts Q.

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

    answer choices True False 2. Multiple-choice 1 minute 5 pts Q.

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

    answer choices Telephone hotlines Mail drops

    In-person reporting to the compliance department/supervisor

    Special Investigation Units (SIUs)

    All of the above 3. Multiple-choice 1 minute 5 pts Q.

    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.

    answer choices True False 4. Multiple-choice 1 minute 5 pts Q.

    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.

    answer choices True False 5. Multiple-choice 1 minute 5 pts Q.

    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.

    answer choices True False 6. Multiple-choice 1 minute 5 pts Q.

    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.

    answer choices True False 7. Multiple-choice 1 minute 5 pts Q.

    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.

    answer choices True False 8. Multiple-choice 1 minute 5 pts Q.

    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.

    answer choices True False 9. Multiple-choice 1 minute 5 pts Q.

    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.

    answer choices True False 10. Multiple-choice 1 minute 5 pts Q.

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

    answer choices

    Civil Monetary Penalties

    Imprisonment

    Exclusion from participation in all Federal health care programs

    All of the above

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    Combating Medicare Parts C and D Fraud, Waste, and Abuse

    Start studying Combating Medicare Parts C and D Fraud, Waste, and Abuse - 2018. Learn vocabulary, terms, and more with flashcards, games, and other study tools.

    Combating Medicare Parts C and D Fraud, Waste, and Abuse - 2018

    4.8 37 Reviews

    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.

    Click card to see definition ๐Ÿ‘†

    True

    Click again to see term ๐Ÿ‘†

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

    Click card to see definition ๐Ÿ‘†

    False

    Click again to see term ๐Ÿ‘†

    1/11 Created by Melinda8675309

    Terms in this set (11)

    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

    Waste indicates 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

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

    True

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

    True

    Ways to report 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

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

    True

    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 Claim Act; the Anti-Kickback Statute; the List of Excluded Individuals and Entities (LEIE); and the Health Care Fraud Statute.

    False

    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/billing

    Ensure you coordinate with you payers

    Keep up to date with FWA policies and procedures, standards of conduct, and Medicare & Medicaid Services (CMS) guidance

    Verify all information provided to you

    True

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

    A. Civil Monetary Penalties

    B. Imprisonment

    C. Exclusion from participation in all Federal healthcare programs

    D. All of the above

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