Healthcare / Medicare Fraud, Abuse, and Waste

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1 / 10

Healthcare / Medicare Fraud, Abuse, and Waste

Question 1:

Which of the following terms refers to billing for services at a higher level of complexity than the service provided or documented?

A) Bundling

B) Upcoding

C) Waste

D) Identity theft

2 / 10

Healthcare / Medicare Fraud, Abuse, and Waste

Question 2:

Which sectors are particularly vulnerable to fraud, abuse, and waste?

A) Primary care

B) Hospice and home health care services

C) Emergency medicine

D) Physical therapy

3 / 10

Healthcare / Medicare Fraud, Abuse, and Waste

Question 3:

Which of the following terms describes the unintentional overuse or misuse of resources that leads to unnecessary costs and does not improve patient outcomes?

A) Healthcare waste

B) Kickbacks

C) Healthcare risk management

D) Data mining

4 / 10

Healthcare / Medicare Fraud, Abuse, and Waste

Question 4:

Healthcare waste is most commonly the result of the following EXCEPT?

A) Systemic issues within a healthcare entity

B) Poor management and administration

C) Greed

D) Inefficient practices and policies

5 / 10

Healthcare / Medicare Fraud, Abuse, and Waste

Question 5:

Which of the following statutes protects specific individuals who disclose information to OIG from retaliation from those who are implicated in fraudulent activity?

A) Whistleblower Protection Act of 1989

B) Federal Protection Agency

C) Witness Protection Program

D) Healthcare Fraud Act

6 / 10

Healthcare / Medicare Fraud, Abuse, and Waste

Question 6:

How does Stark Law help to regulate healthcare practices and manage risk?

A) It allows pharmaceutical companies to provide financial incentives to physicians in exchange for patient prescriptions.

B) It forces physicians only to prescribe generic drugs.

C) It restricts providers in referring only to specific specialties.

D) It prevents providers from referring Medicare patients to entities the provider owns without disclosure.

7 / 10

Healthcare / Medicare Fraud, Abuse, and Waste

Question 7:

If a healthcare professional suspects fraud, abuse, or waste, what should they do?

A) Confront the individual(s) suspected of fraudulent activity.

B) Ignore it because it is not within their job description.

C) Wait until an audit or performance review occurs.

D) Report it through the appropriate regulatory agency or hotline.

8 / 10

Healthcare / Medicare Fraud, Abuse, and Waste

Question 8:

Fraud, abuse, and waste only impact the insurance company or government program responsible for reimbursement.

A) True

B) False

9 / 10

Healthcare / Medicare Fraud, Abuse, and Waste

Question 9:

Which of the following are outlets for reporting healthcare and Medicare fraud?

A) The Medicare Hotline

B) The Office of the Inspector General

C) Filing of False Claim Act lawsuit

D) All of the above.

10 / 10

Healthcare / Medicare Fraud, Abuse, and Waste

Question 10:

Studies estimate that up to 10% of overall healthcare spending is lost due to healthcare fraud.

A) True

B) False

Your score is

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