CPB Study Guide 2024 with Complete Solutions
ABUSE - ANSWER-an action that results in unnecessary costs to a federal healthcare program, either
directly or indirectly
CONDITIONS OF PARTICIPATION (COP) - ANSWER-conditions that healthcare organizations must meet
to participate with the plan or pr...
ABUSE - ANSWER✔✔-an action that results in unnecessary costs to a federal healthcare program, either
directly or indirectly
CONDITIONS OF PARTICIPATION (COP) - ANSWER✔✔-conditions that healthcare organizations must meet
to participate with the plan or program
COVERED ENTITY - ANSWER✔✔-according to HIPAA, defined as health plans, healthcare clearinghouses,
and healthcare providers who electronically transmit any health information in connection with
transactions for which HHS has adopted standards
FALSE CLAIMS ACT (FCA) - ANSWER✔✔-Federal statute setting criminal and civil penalties for falsely
billing the government, over-representing the amount of a delivered product, or under-stating an
obligation to the government
FRAUD - ANSWER✔✔-making false statements or misrepresenting facts to obtain an undeserved benefit
or payment from a federal healthcare program
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA) - ANSWER✔✔-federal law
in which the primary goal is to make it easier for people to keep health insurance, protect the
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