All MOD AHIP: Final Exam 2020 AHIP, 2022 AHIP, AHIP questions with all the correct answers (Actual test 100% verified)

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You are performing a regular inventory of the controlled substances in the pharmacy. You discover a minor inventory discrepancy. What should you do? {{Correct Ans- Follow your pharmacy's procedures ... You work for a Sponsor. Last month, while reviewing a Centers for Medicare & Medicaid Services (CMS) monthly report, you identified multiple individuals not enrolled in the plan but for whom the Sponsor is paid. You spoke to your supervisor who said don't worry about it. This month, you identify the same enrollees on the report again. What should you do? {{Correct Ans- Although you know about the Sponsor's non-retaliation policy, you are still nervous about reporting—to be safe, you submit a report through your compliance department's anonymous tip line to avoid identification You discover an unattended email address or fax machine in your office receiving beneficiary appeals requests. You suspect no one is processing the appeals. What should you do? {{Correct Ans- Contact your compliance department (via compliance hotline or other mechanism) A sales agent, employed by the Sponsor's first-tier, downstream, or related entity (FDR), submitted an application for processing and requested two things: 1) to back-date the enrollment date by one month, and 2) to waive all monthly premiums for the beneficiary. What should you do? {{Correct Ans- Process the application properly (without the requested revisions)—inform your supervisor and the compliance officer about the sales agent's request Ways to report a compliance issue include: a.In-person reporting to the compliance department/supervisor b.Report on the Sponsor's website c.Telephone hotlines d.All of the above {{Correct Ans- All of the above Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper Management only. {{Correct Ans- False What is the policy of non-retaliation? {{Correct Ans- Protects employees, who in good faith report suspected non-compliance Medicare Parts C and D sponsors are not required to have a compliance program. {{Correct Ans- False At a minimum, an effective compliance program includes four core requirements. {{Correct Ans- False Correcting non-compliance________ {{Correct Ans- Protects enrollees, avoids recurrence of same non-compliance, and promotes efficiency These are examples of issues that can be reported to a Compliance Department: suspected fraud, waste, and abuse (FWA), potential health privacy violation, and unethical behavior/employee misconduct. {{Correct Ans- True Once a corrective action plan begins addressing non-compliance for fraud, waste, and abuse (FWA) committed by a Sponsor's employee or first-tier, downstream, or related entity's (FDR's) employee, ongoing monitoring of the corrective actions is not necessary. {{Correct Ans- False Standards of Conduct are the same for every Medicare Parts C and D sponsor. {{Correct Ans- False What are some of the consequences for non-compliance, fraudulent, or unethical behavior? a.Exclusion from participating kin all Federal health care programs b.Termination of employment c.Disciplinary action d.All of the above {{Correct Ans- All of the above [Show More]

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