Anti kickback statute - Study guides, Class notes & Summaries

5 most important federal fraud and abuse laws: correct answers*False Claims Act (FCA) *Anti - kickback Statute (AKS) *Physician Self-Referral Law (Stark I II III ) *Exclusion Authorities *Civil Monetary Penalties Law (CMPL) The purpose of EMTALA is to prevent: a. Hospitals from rejecting patients in a discriminatory manner by, refusing treatment, or transferring patients to "charity hospitals" or "county hospitals," because they are unable to pay. b. Hospitals from admitting patient...

AAPC CPB Chapter 1-5Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination of benefits d. Physician unique identifier number - correct answer d. Physician unique identifier number A physician received office space at a reduced rate for referring patients to the hospital's out- patient physical therapy ce...

CHAA Study Guide Latest Version Graded A Accreditation Defined as "a self-assessment and external peer assessment process used by healthcare organizations to accurately assess their level of performance in relation to established standards and to implement ways to continuously improve." Examples include: TJC, Healthcare Accreditation Program, DNVGL helps organize patient safety efforts, improves risk management, provides education, provides professional advice, authority for Med...

AAPC Chapter 1 CPB: Exam Review Questions and answers/ A physician received office space at a reduced rate for referring patients to the hospital's outpatient physical therapy center. What Law does this violate? 1. Anti-kickback Statute 2. Stark Law 3. False Claims Act 4. Truth in Lending Act - -Anti-Kickback Statute Rationale: The anti-kickback Laws states that anyone who knowingly or willing accept or offer any items or services to induce referral is a violation of the law. Feder...

AABB - ANSWER American Association of Blood Banks; one of six CMS- approved accreditation organizations Abuse - ANSWER Improperly, and often unknowingly, violating regulations ALJ hearing - ANSWER The third level of Medicare appeal; the amount in controversy threshold for 2012 is $130 American Association of Blood Banks - ANSWER AABB; one of six CMS - approved accreditation organizations. American Osteopathic Association - ANSWER AOA; one of six CMS - approved accreditation organizat...

AABB - ANSWER American Association of Blood Banks; one of six CMS- approved accreditation organizations Abuse - ANSWER Improperly, and often unknowingly, violating regulations ALJ hearing - ANSWER The third level of Medicare appeal; the amount in controversy threshold for 2012 is $130 American Association of Blood Banks - ANSWER AABB; one of six CMS - approved accreditation organizations. American Osteopathic Association - ANSWER AOA; one of six CMS - approved accreditation organizat...

Actuary Ans: a person who uses statistics to compute loss probabilities to establish premiums for insurance companies and self-insurance trusts. Advance directive Ans: lawful written instruction that describes an individual's preferences for health care should he or she become unable to express them later. Examples+ living wills, power of attorney for health care, advance health care directive. Adverse event Ans: any injury (undesirable clinical outcome anticipated or not anticipated...

Center for Medicare and Medicaid Services (CMS) CORRECT ANSWER The Centers for Medicare & Medicaid Services, is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program, and health insurance portability standards. Waste CORRECT ANSWER Incurring unnecessary costs as a result of deficient management, practices, or control...

AAPC CPB Chapter 1-5. Questions and answers, rated A+ Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination of benefits d. Physician unique identifier number - -d. Physician unique identifier number A physician received office space at a reduced rate for referring patients to the hospital's out- patient...

Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination of benefits d. Physician unique identifier number - ANSWERSd. Physician unique identifier number A claim is received by a payer that subsequently requests the medical records for the date of service on the claim. What procedure should be followed by th...