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CPMA Top exam questions and answers, 100% Accurate, rated A+
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CPMA Top exam questions and answers, 100% Accurate, rated A+ Fraud or Abuse: Billing for a service at a higher level than provided - -Fraud What is a Qua Tam relator? - -A person who brings a civil action for a violation for him/herself & for US Govt What is the difference between Stark ...

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  • February 16, 2023
  • 8
  • 2022/2023
  • Exam (elaborations)
  • Questions & answers

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  • cpma top exam questions and answers
  • 100 accurate
  • rated a fraud or abuse billing for a service at a higher level than provided fraud what is a qua tam relator a person who brings a civil

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CPMA Top exam questions and answers,
100% Accurate, rated A+

Fraud or Abuse: Billing for a service at a higher level than provided - ✔✔-Fraud



What is a Qua Tam relator? - ✔✔-A person who brings a civil action for a violation for him/herself & for
US Govt



What is the difference between Stark Law & Antikickback law? - ✔✔-No INTENT must be provien for
Stark, Antikickpack requires proof of intent



When banned for Fed/State healthcare program, what is the term of exclusion (in Years)? - ✔✔-5 years



How often are the OIG workplans updated? - ✔✔-Monthly online



The FCA allows for reduced penalties if the person committing the violation does what? - ✔✔-Self
discloses



Fraud or Abuse? Misrepresenting a DX to justify payment? - ✔✔-Fraud



Fraud or Abus? Improper billing practices - ✔✔-Abuse



Fraud or Abuse? Altering claim forms and/or receipts to receive a higher payment amount. - ✔✔-Fraud



Fraud or Abuse? Billing Medicare patients a higher fee schedule compared to non-Medicare patients. -
✔✔-Abuse



What does FCA stand for? - ✔✔-Federal False Claims Act

, How else is the Start Law referred? - ✔✔-Physician self-referral law



How many federal OIGs are there? - ✔✔-73



What is the CIA? - ✔✔-Corporate Integrity Agreements lasting typically 5 years as a guideline to help
providers that have been excluded.



When CIAs require claim reviews what is considered the DISCOVERY sample? - ✔✔-50 claims randomly
selected (95% accuracy required)



What are the fundamental elements for an effective compliance program? - ✔✔-1. Written policies 2.
Compliance officer/committee 3. Training/education 4. Communication 5.Enforcement of standars &
disciplinary actions 6. Internal audtis 7. respond & develope corrective action plan



In a Corporate Integrity Agreement (CIA) does the OIG specify the IRO to be used? - ✔✔-NO, but the OIG
does retain the right to notify the provider if they must select a new IRO



When non-compliance is identified, what does the OIG suggest? - ✔✔-Take disciplinary action &
document the date of the incident, the name of the reporting party, name of the person responsible for
taking action and the f/u action taken.



The OIG lists potential risks for individual/small group practices compliance plans. Name a potential risk
area - ✔✔-UNBUNDLING



What are the three key components of E&M? - ✔✔-HX, Exam & MDM



If there is an issue of GAIT determined in the patient's exam, how could that be counted in the EXAM
depending on the patient's condition? - ✔✔-Neurology or M/S



What are the CCI indicators - ✔✔-0 NOT ALLOWED 1 Allowed with supporting documentation 9 DOES
NOT Apply

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