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Exam (elaborations)

Cpma Exam Questions and Answers| 100% Pass

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Cpma Exam 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...

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  • October 3, 2024
  • 82
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • CPMA
  • CPMA
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EmillyCharlotte
EMILLYCHARLOTTE 2024/2025 ACADEMIC YAER
©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED
FIRST PUBLISH SEPTEMBER 2024

Cpma Exam 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. - Answer✔✔-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?



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,EMILLYCHARLOTTE 2024/2025 ACADEMIC YAER
©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED
FIRST PUBLISH SEPTEMBER 2024
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. - Answer✔✔-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?



a. Unbundling



b. Under Coding



c. Overuse of E/M codes



d. Failure to follow the "same day" rule - Answer✔✔-a. Unbundling

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

conditions exist?




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,EMILLYCHARLOTTE 2024/2025 ACADEMIC YAER
©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED
FIRST PUBLISH SEPTEMBER 2024
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.



d. All of the above - Answer✔✔-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. - Answer✔✔-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.


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, EMILLYCHARLOTTE 2024/2025 ACADEMIC YAER
©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED
FIRST PUBLISH SEPTEMBER 2024
b. TriCare's Compliance of Physicians Guidance

c. Medicaid's Coordination of Physician Groups

d. Commercial Programs - Answer✔✔-a. Medicare Conditions of Participation.

When a provider is excluded under the Exclusions statute, What must he or she do at

the end of the exclusionary period?



a. the provider is automatically reinstated



b. The provider must apply for reinstatement.



c. The provider cannot be reinstated once excluded.



d. The provider must apply for a group provider number. - Answer✔✔-b. The provider

must apply for reinstatement

Which option is considered a material breach of CIA?



a. Failure to engage and use an IRO in accordance with the CIA.



b. Failure to hire an OIG employee to oversee compliance efforts.



c. Failure to hire a full-time internal auditor to review every claim before it is submitted.




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