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CDEO CHAPTER 3 UPDATED /QUESTIONS WITH COMPLETE SOLUTIONS (A+)
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CDEO CHAPTER 3 UPDATED /QUESTIONS WITH COMPLETE SOLUTIONS (A+)
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CDEO CHAPTER 3 UPDATED 2024-2025/QUESTIONS WITH COMPLETE SOLUTIONS
(A+)
It states a person is liable who:
A) Knowingly presents, or causes to be presented, a false or
fraudulent claim for payment or approval;
B) Knowingly makes , uses, or causes to be made or used, a
false record or statement material to a false or fraudulent claim
Title 31 Statute's 7 Types of Conduct Correct Answer C)
Conspires to a violation of subparagraph (A), (B), (E), (F), or (G);
D) Has posession, custody, or control of property or money used,
or to be used, by the government and knowingly delivers, or
causes to be delivered , less than all of that money or property;
Title 31 Statute's 7 Types of Conduct Correct Answer E) Is
authorized to make or deliver a document certifying receipt of
property used, or to be used, by the government, and intending to
defraud the government, makes or delivers the receipt without
completely knowing that the information on the receipt is true
F) Knowingly buys or receives as a pledge of an obligation or
debt, public property from an officer or employee of the
government or a member of the Armed Forces, who lawfully may
not sell or pledge property
Title 31 Statute's 7 Types of Conduct Correct Answer G)
Knowingly makes, uses, or causes to be made or used, a false
record or statement material to an obligation to pay or transmit
money or property to the government, or knowingly conceals or
,knowingly and improperly avoids or decreases an obligation to
pay to transmit money or property to the government
FCA Fraud & Misconduct Correct Answer -Falsifying a medical
chart notation
-Submitting claims for services not performed, not request, not
necessary
-Submitting claims for expired drugs
-Upcoding and/or unbundling services
-Submitting claims for physician services performed by a NPP
without regard to incident to guidelines
Reverse False Claims Section Correct Answer Section 3729a.I.G
It provides liability where a person acts improperly to avoid paying
money owed to the government.
Requires the knowledge that it is false to be fraud.
Section 3729b.1. Correct Answer Defines the terms Knowing and
Knowingly such that a person must act in deliberate ignorance of
the truth or falsity of the relevant information, or acts in reckless
disregard of the truth or falsity of the information; however, the act
states that a violation may occur even if there no intent to defraud
The FCA is not violated merely by submitting a false claim, but
rather by submitting or causing to be submitted a false claim with
the knowledge that it is false.
Title 31 Statute Correct Answer originally provided for a civil
penalty of $5,000 and not more than $10,000 per claim plus 3x
the amount of government damage if FCA liability was found
FCPIA Correct Answer Federal Civil Penalties Inflation
Adjustment Act
, Current penalties $10,781 to $21,563 per claim. also liable for the
costs of the civil action brought to recover any such penalties or
damages
Also contains a criminal statute that can result in criminal
penalties.
Self Disclosing Violation Correct Answer FCA allows for reduced
penalties (mitigation) if the person committing the violation come
forward
3729.a.2 Correct Answer states a court may assess not less than
2x the amount of damages the government sustains because of
the act of the person
Self Disclosing 37.29.a.2 Correct Answer A) the person
responsible furnishes officials of the US responsible for
investigating false claims violations with all information known to
such a person about the violation within 30 days after the date of
which the defendant first obtained the information;
Self Disclosing 37.29.a.2 Correct Answer B) Such person fully
cooperates with the investigation of such violation, and
C) at the time such person furnishes the information about the
violation, no criminal prosecution, civil action, or administrative
action has commenced under this title with respect to the
violation, and the person did not had actual knowledge of the
existence of an investigation into such a violation
31 U.S.C 3729 (a) 1 Examples Correct Answer 1. Falsifying a
medical chart notation
2. Submitting a cliams for services not performed, not requested,
or unnecessary
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