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Exam (elaborations)

cpma Questions and Answers (100% Pass)

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When non-compliance is identified, what does the OIG recommended? a .Take disciplinary action and document the date of the incident, name of the reporting party, name of the person responsible for taking action, and the follow-up action taken. b. Take disciplinary action and document the date...

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  • October 18, 2024
  • 108
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • CPMA
  • CPMA
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cpma Questions and Answers
(100% Pass)
When non-compliance is identified, what does the OIG recommended?




a .Take disciplinary action and document the date of the incident, name of

the reporting party, name of the person responsible for taking action, and the

follow-up action taken.




b. Take disciplinary action and document the date of the incident, name of

the reporting party, name of the person responsible for taking action,and the

follow-up action taken.




c. Immediately terminate employment for the party found in non-

compliance,regardless of the severity of the offense,document the date of

the termination,file a corrected claim on all claims affected.




d. Continue to watch the employee in non-compliance until the incidents

meet a federal level before taking action.




Master01 | September, 2024/2025 | Latest update

, 1 | P a g e | © copyright 2024/2025 | Grade A+

✓ b. Take disciplinary action and document the date of the incident,

name of the reporting party, name of the person responsible for taking

action,and the follow-up action taken




A provider consistently charges a higher level E/M service than is

documented to help cover the cost of his declining practice. Would this be

fraud or abuse Why?




a. Abuse,charging one level higher on each visits does not show intent.




b. Abuse; the provider's practice is common and therefore would not be

considered fraudulent .




c. Fraud; and over-coding of services would be considered fraudulent.




d. Fraud; the provider intentionally over-coded to gain financially.


✓ d. Fraud; the provider intentionally over-coded to gain financially.




The OIG lists potential risk areas for individual and small physician groups in

the compliance plan guidance. Which option below is listed as a risk area?



Master01 | September, 2024/2025 | Latest update

, 1 | P a g e | © copyright 2024/2025 | Grade A+




a. Unbundling




b. Under Coding




c. Overuse of E/M codes




d. Failure to follow the "same day" rule


✓ a. Unbundling




The FCA allows for reduced penalties if the person in violation self-discloses if

which conditions exist?




a. The person furnishes all information about the violation with in 30 days after

which the defendant first obtained the information.




b. The person fully cooperates with the investigation.




c. There is no additional criminal prosecution, civil action, or administrated

action with the respect to the violation.

Master01 | September, 2024/2025 | Latest update

, 1 | P a g e | © copyright 2024/2025 | Grade A+




d. All of the above


✓ d. All of the above




What is a Qui Tam Relator?


a. a person who is prosecuted under FCA.




b. The defendant in a Stark Law case.




c. a person listed on the OIG exclusions list.




d. a person who brings civil action for violation under the FCA for themselves

and the government.


✓ d. a person who brings civil action for violation under the FCA for

themselves and the government.




What is CoP?




a. Medicare Conditions of Participation.


b. TriCare's Compliance of Physicians Guidance

Master01 | September, 2024/2025 | Latest update

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