Fraud, Waste, Abuse FWA - 2, Fraud
Waste and Abuse, Preventing Fraud,
Abuse & Waste, Fraud, Abuse, and
Waste, Fraud Waste and Abuse 2018
AHIP, fraud, waste, and abuse
prevention. Top Questions and answers,
100% Accurate.
e - ✔✔-Ways to report potential Fraud, Waste, and Abuse (FWA) include:
a. Telephone hotlines
b. Mail Drops
c. In-person reporting to the compliance department/supervisor
d. Special Investigations Units (SIUs)
e. All of the above
false - ✔✔-Once a corrective action plan is started, the corrective actions must be monitored annually to
ensure they are effective.
:
True False
false - ✔✔-Any person who knowingly submits false claims to the Government is liable for five times the
Government's damages caused by the violator plus a penalty.
:
True False
,true - ✔✔-These are examples of issues that should be reported to a Compliance Department:
suspected Fraud, Waste, and Abuse (FWA); potential health privacy violation, and unethical
behavior/employee misconduct.
:
True False
true - ✔✔-Bribes or kickbacks of any kind for services that are paid under a Federal health care program
(which includes Medicare) constitute fraud by the person making as well as the person receiving them.
:
True False
true - ✔✔-Waste includes any misuse of resources such as the overuse of services, or other practices
that, directly or indirectly, result in unnecessary costs to the Medicare Program.
:
True False
ACA Section 1557 differs from earlier legislation in providing broader protection against discrimination
based on - ✔✔-sex
Section 1557 of the Affordable Care Act applies to - ✔✔-c. all health programs and activities
administered by or receiving federal financial assistance from HHS. Correct
Which Medicare programs are covered by ACA Section 1557? - ✔✔-a. Parts A, C, and D, but not B.
Correct
Under ACA Section 1557, prohibited actions involve - ✔✔-d. eligibility, claims, and marketing. Correct
Under ACA Section 1557, a person - ✔✔-c. cannot be discriminated against based on her legal or illegal
immigration status or ability to speak English. Correct
, Under ACA Section 1557, a health plan - ✔✔-d. cannot deny coverage to LEP individuals and is required
to provide language assistance to them, free of charge. Correct
Which of these actions is most likely to be permitted in dealing with a person with limited English
proficiency? - ✔✔-a. Allowing a child to interpret in an emergency. Correct
Under ACA Section 1557, sex discrimination includes a person's - ✔✔-c. sex, pregnancy, sex stereotypes,
or gender identity. Correct
Under ACA Section 1557, a health plan sold through a state exchange may, based on an individual's age,
- ✔✔-d. charge higher premiums. Correct
ACA Section 1557 rules for disability concern - ✔✔-d. Policies and procedures, physical access, and
communication. Correct
Which area of potential discrimination is not generally covered by ACA Section 1557? - ✔✔-c.
Employment (with the exception of the provision of health insurance). Correct
As a result of violations of ACA Section 1557 nondiscrimination rules, - ✔✔-c. a health plan may revoke
an agent or broker's appointment with the health plan. Correct
For a health plan, what are the possible consequences of violations of ACA Section 1557? - ✔✔-b. Loss
of federal business and compensatory damages. Correct
If a health plan violates ACA Section 1557 nondiscrimination protections, it may be - ✔✔-c. required to
take corrective action and sometimes pay damages, and it may be sued by individuals. Correct
Ways to report potential Fraud, Waste, and Abuse (FWA) include: - ✔✔-e. All of the above Correct
Once a corrective action plan is started, the corrective actions must be monitored annually to ensure
they are effective. - ✔✔-False
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