Combating Medicare Parts C and D Fraud, Waste, and Abuse – 2012/2023 Already Passed

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Combating Medicare Parts C and D Fraud, Waste, and Abuse – 2012/2023 Already Passed Bribes or kickbacks of any kind for services that are paid under a Federal healthcare program (which includes ... Medicare) constitute fraud by the person making as well as the person receiving them. ✔✔True Once a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective. ✔✔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. ✔✔False Waste indicates 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. ✔✔True 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. ✔✔True Abuse involves payment for items or services when there is no legal entitlement to that payment and the provider has not knowingly and/or intentionally misrepresented facts to obtain payment. ✔✔True Ways to report fraud, waste, and abuse (FWA) include: A. Telephone hotlines B. Mail drops C. In-person reporting to the compliance department/supervisor D.Special Investigations Units (SIUs) ✔✔E. All of the above 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. ✔✔True Some of the laws governing Medicare Parts C and D Fraud, Waste, and Abuse (FWA) include the Health Insurance Portability and Accountability Act (HIPAA); the False Claim Act; the AntiKickback Statute; the List of Excluded Individuals and Entities (LEIE); and the Health Care Fraud Statute. ✔✔False You can help prevent fraud, waste, and abuse (FWA) by doing all of the following: Look for suspicious activity Conduct yourself in an ethical manner Ensure accurate and timely data/billing Ensure you coordinate with you payers Keep up to date with FWA policies and procedures, standards of conduct, and Medicare & Medicaid Services (CMS) guidance Verify all information provided to you ✔✔True What are some of the penalties for violating fraud, waste, and abuse (FWA) laws? A. Civil Monetary Penalties B. Imprisonment C. Exclusion from participation in all Federal healthcare programs ✔✔D. All of the above [Show More]

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