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CPMA- Chapter one exam Questions And Answers
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CPMA- Chapter one exam Questions And Answers A provider consistently charges a higher level of E/M service than is documented to help cover the cost of his declining practice. Would this be fraud or abuse, and why? a. Abuse; the provider's practice is common and therefore would not be conside...

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  • October 19, 2024
  • 15
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • cpma chapter one exam questions and answers

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CPMA- Chapter one exam Questions And
Answers

A provider consistently charges a higher level of E/M service than is documented to help cover

the cost of his declining practice. Would this be fraud or abuse, and why?




a. Abuse; the provider's practice is common and therefore would not be considered fraudulent.




b. Abuse; charging one level higher on each visit does not show intent.




c. Fraud; the provider intentionally over-coded to gain financially.




d. Fraud; any over-coding of services would be considered fraudulent. C. Fraud; the

provider intentionally over-coded to gain financially.




Response Feedback: Rationale: The difference between fraud and abuse is intent.




Based on the compliance program guidance documents by the OIG, what should be documented

when non-compliant conduct is found?

, CPMA- Chapter one exam Questions And
Answers
A. Action found to be non-compliant, date the employee's name was reported to the OIG.




b. Date of the incident, date of termination of the employee in non-compliance.




c. Date of incident, name of the reporting party, name of the person responsible for taking action,

follow-up action taken.




d. Date of the incident, date the OIG received the report on the investigation. c. Date of

incident, name of the reporting party, name of the person responsible for taking action, follow-up

action taken.




Rationale: The Stark law has strict liability regarding overpayments, meaning no intent must be

proven. For civil monetary penalties for the Stark law, though, intent is required for knowing

violations. The Anti-Kickback law requires proof of intention. The law states the person must

"knowingly and willfully" violate the law. The "willful" verbiage is not found in the Stark law.




Under a CIA, 50 sampling units are selected for review. What is this sample referred to as?

a. Discovery sample

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