CITI Ethics, Responsible Conduct, RCR, Law, HTH And IRB > EXAM > AHIP fraud waste & abuse questions and answers already passed (All)
Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? ✔✔Fraud Which of the following is not potentially a penalty for violation of the law or r... egulation prohibiting fraud, waste and abuse (fwa)? ✔✔Deportation A person comes into your pharmacy to drop off a prescription for a beneficiary who is a regular customer. The prescription is for a controlled substance with a quantity of 160. This beneficiary normally receives a quantity of 60, not 160. You review the prescription and have concerns about the possible forgery. What is your next step? ✔✔Call the prescriber to verify the quantity Your job is to submit risk diagnosis to the centers for Medicare & medicaid services (cms) for the purpose of payment. As part of this job you verify, through a certain process, that the data is accurate. Your immediate supervisor tells you to ignore the sponsors process and to adjust/add risk diagnosis codes for certain individuals. What should you do? ✔✔Report the incident to the compliance department (via compliance hotline or other mechanism) [Show More]
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