Fraud
Waste
and
Abuse
questions
with
correct
answers
2024
ACA
Section
1557
differs
from
earlier
legislation
in
providing
broader
protection
against
discrimination
based
on
-
answer-sex
Section
1557
of
the
Affordable
Care
Act
applies
to
-
answer-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?
-
answer-a.
Parts
A,
C,
and
D,
but
not
B.
Correct
Under
ACA
Section
1557,
prohibited
actions
involve
-
answer-d.
eligibility,
claims,
and
marketing.
Correct
Under
ACA
Section
1557,
a
person
-
answer-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
-
answer-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?
-
answer-a.
Allowing
a
child
to
interpret
in
an
emergency.
Correct
Under
ACA
Section
1557,
sex
discrimination
includes
a
person's
-
answer-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,
-
answer-d.
charge
higher
premiums.
Correct
ACA
Section
1557
rules
for
disability
concern
-
answer-d.
Policies
and
procedures,
physical
access,
and
communication.
Correct
Which
area
of
potential
discrimination
is
not
generally
covered
by
ACA
Section
1557?
-
answer-c.
Employment
(with
the
exception
of
the
provision
of
health
insurance).
Correct
As
a
result
of
violations
of
ACA
Section
1557
nondiscrimination
rules,
-
answer-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?
-
answer-b.
Loss
of
federal
business
and
compensatory
damages.
Correct
If
a
health
plan
violates
ACA
Section
1557
nondiscrimination
protections,
it
may
be
-
answer-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:
-
answer-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.
-
answer-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.
-
answer-False
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.
-
answer-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.
-
answer-True
Correct
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.
-
answer-True
You
can
help
prevent
Fraud,
Waste,
and
Abuse
(FWA)
by
doing
all
of
the
following:
•
Look
for
suspicious
activity;
•
Conduct
yourself
in
an
ethical
manner;
•
Ensure
accurate
and
timely
data/billing;
•
Ensure
you
coordinate
with
other
payers;
•
Keep
up
to
date
with
FWA
policies
and
procedures,
standards
of
conduct,
laws,
regulations,
and
the
Centers
for
Medicare
&
Medicaid
Services
(CMS)
guidance;
and
•
Verify
all
information
provided
to
you.
-
answer-F
What
are
some
of
the
penalties
for
violating
Fraud,
Waste,
and
Abuse
(FWA)
laws?
-
answer-all
of
the
above
Some
of
the
laws
governing
Medicare
Parts
C
and
D
Fraud,
Waste,
and
Abuse
(FWA)
include
the
Health
Insurance
Portability
and
Accountability
Act
(HIPAA);
the
False
Claims
Act;
the
Anti-Kickback
Statute;
the
List
of
Excluded
Individuals
and
Entities
(LEIE);
and
the
Health
Care
Fraud
Statute.
-
answer-false