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Fraud Waste And Abuse – Questions And Answers
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Fraud Waste And Abuse – Questions And AnswersACA Section 1557 differs from earlier legislation in providing broader
protection against discrimination based on ✔️Ans - sex
Section 1557 of the Affordable Care Act applies to ✔️Ans - 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? ✔️Ans -
a. Parts A, C, and D, but not B. Correct
Under ACA Section 1557, prohibited actions involve ✔️Ans - d.
eligibility, claims, and marketing. Correct
Under ACA Section 1557, a person ✔️Ans - 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 ✔️Ans - 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? ✔️Ans - a. Allowing a child to
interpret in an emergency. Correct
Under ACA Section 1557, sex discrimination includes a person's ✔️Ans
- 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, ✔️Ans - d. charge higher premiums.
Correct
ACA Section 1557 rules for disability concern ✔️Ans - d. Policies and
procedures, physical access, and communication. Correct
, Which area of potential discrimination is not generally covered by ACA
Section 1557? ✔️Ans - c. Employment (with the exception of the
provision of health insurance). Correct
As a result of violations of ACA Section 1557 nondiscrimination rules,
✔️Ans - 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? ✔️Ans - b. Loss of federal business and compensatory
damages. Correct
If a health plan violates ACA Section 1557 nondiscrimination protections, it
may be ✔️Ans - 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: ✔️Ans
- 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. ✔️Ans - 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. ✔️Ans - 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. ✔️Ans
- 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. ✔️Ans - 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. ✔️Ans - True
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