Medicare Fraud, Waste and Abuse Exam Questions and Answers
1 view 0 purchase
Course
AHIP abuse
Institution
AHIP Abuse
Which of the following requires intent to obtain payment and the knowledge the actions are wrong?
Question 1Select one:
a. Abuse
b. Fraud
c. Waste - Answer-Fraud
Your job is to submit a risk diagnosis to the Centers for Medicare & Medicaid Services (CMS) for the purpose of payment. As part o...
Medicare Fraud, Waste and Abuse Exam
Questions and Answers
Which of the following requires intent to obtain payment and the knowledge the actions
are wrong?
Question 1Select one:
a. Abuse
b. Fraud
c. Waste - Answer-Fraud
Your job is to submit a risk diagnosis to the Centers for Medicare & Medicaid Services
(CMS) for the purpose of payment. As part of this job, you use a process to verify the
data is accurate. Your immediate supervisor tells you to ignore the Sponsor's process
and to adjust or add risk diagnosis codes for certain individuals. What should you do?
Question 2Select one:
a. Call law enforcement
b. Discuss your concerns with your immediate supervisor
c. Do what your immediate supervisor asked you to do and adjust or add risk diagnosis
codes
d. Report the incident to the compliance department (via compliance hotline or other
mechanism) - Answer-D - Report the incident to the compliance department (via
compliance hotline or other mechanism)
Which of the following is NOT potentially a penalty for violation of a law or regulation
prohibiting fraud, waste, and abuse (FWA)?
Question 3Select one:
a. Deportation
b. Exclusion from participation in all Federal health care programs
c. Civil Monetary Penalties - Answer-Deportation
A person drops 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 160. You review the prescription and have
concerns about possible forgery. What is your next step?
Question 4Select one:
a. Fill the prescription for 60
b. Fill the prescription for 160
c. Call the Sponsor's compliance department
d. Call law enforcement
e. Call the prescriber to verify the quantity - Answer-Call the prescriber to verify the
quantity
You are performing a regular inventory of the controlled substances in the pharmacy.
You discover a minor inventory discrepancy. What should you do?
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller lectknancy. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.49. You're not tied to anything after your purchase.
