CPCO Exam Prep | 36 Questions and
Answers 100% Solved
Hospitals are prohibited from making payments, directly or indirectly, to a physician as an
inducement to reduce or limit services provided to Medicare or Medicaid patients. The hospital
is subject to a civil money penalty of not more than how much for each individual for whom a
payment is made? - ✔✔$2,000
Tim is the Compliance Officer for the Apple Internal Medicine Group. He conducts the in-service
training for all new employees. He discusses the 5 most important federal fraud and abuse laws.
These are: - ✔✔FCA, AKS, Stark, Exclusion, CMPL
Joan is an employee at XYZ Family Practice. She asks the Compliance Office what should you do
when you find out one of your employees has been excluded from government programs? -
✔✔Suspend the employee, request documentation, and investigate the matter.
Which Act authorized the imposition of Civil Monetary Penalties against health care providers
and entities that employ or enter into contracts with excluded individuals or entities to provide
items or services to federal program beneficiaries? - ✔✔The Balanced Budget Act (BBA)
Hannah is afraid that if she reports the allegation of fraud that she thinks is occurring at her
medical office that she will be fired. Could this occur? - ✔✔Yes, but the employer would be in
violation of the Whistleblower Protection Law.
If the government intervenes in the qui tam action, the relator is entitled to receive how much
of the amount recovered by the government through the qui tam action? - ✔✔between 25 and
30 percent
Which law provides for a civil monetary penalty (up to $15,000 per service) and exclusion from
government programs in any case where a person submits an improper claim, which was known
, to have been, or should have been known to have been, provided through a prohibited referral,
and has not refunded the payment? - ✔✔Stark
Texas orthopedics submits false Medicare claims through its electronic data interchange to its
Medicare Administrative contractor based in Oklahoma. Can the orthopedic office be charged
with federal wire fraud? - ✔✔Yes, because false claims were submitted electronically across
state lines.
Penalties for mail fraud where the person knowingly and willfully schemes to defraud a health
care benefit program includes fines and imprisonment of up to how many years? - ✔✔10 years
FERA expands the grounds for liability under which Act. - ✔✔False Claims Act
The Office of Civil Rights (OCR) has enforcement power for violations occurring as a result of
willful neglect. The OCR can now impose civil monetary penalties of up to how much per HIPAA
privacy regulations violation. - ✔✔$50,000
Judy is the front office assistant at XYZ Family Practice Group. She wants to know why she can't
waive co-pays on a regular basis if the patient can't pay. Routine waiver of co-payments or
deductibles for patients under Medicare Part B is in violation of what Statute? - ✔✔Antikickback
Which Act of 2003 gave momentum to the e-prescribing movement, and was put in place to
reduce medication errors due to illegible physician handwriting, etc.? - ✔✔Medicare
Modernization Act (MMA)
The CMP Inflation Adjustment increased the maximum penalty amount per false claim to? -
✔✔10,781-$21,563, plus the assessment of not more than three times the amount claimed for
damages
In a qui tam action in which the government intervenes, the relator is entitled to receive a
monetary settlement between? - ✔✔15-25%
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