Fraud, Waste and Abuse

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Email *

Name *

Which branch office of Heartland PCA do you work for? *

Bemidji

Duluth

Finlayson

Hibbing

What does FWA stand for? *

1 point

Fraud is the intentional act of deception, misrepresentation or concealment in order to gain something of value. *

1 point

True

False

Which of the following are examples of fraud? *

1 point

Billing for services that were never provided

Claiming to work hours that were never actually worked

Submitting accurate, completed and honest timesheets

A & B

All of the above

None of the above

It is okay for prescriber's (doctors, for example) to write prescriptions for medications that are not medically necessary? *

1 point

True

False

Doctor shopping-visiting different doctors to obtain multiple prescriptions-is an example of FWA. *

1 point

True

False

Using somebody else's ID card to obtain prescriptions, services, doctor visits, etc. is not an example of FWA. *

1 point

True

False

Examples of billing fraud include: *

1 point

Billing for services not provided

Misrepresenting the service that was provided

Billing for higher level care than the service actually delivered

Billing for non-covered services or prescriptions as covered services

All of the above

None of the above

All of the following are true for reporting suspected or actual FWA, except: *

1 point

Report all suspected or actual FWA

Report all suspected or actual noncompliance with regulations

Penalties or retribution for reporting any suspected misconduct or noncompliance are possible and allowed

We are all responsible for compliance and ensuring that we follow laws and regulations that govern our work. *

1 point

True

False

Match up the definition with the correct law it represents: *

3 points

Makes it a crime to knowingly & willfully offer, pay, solicit, or receive, directly or indirectly, anything of value to induce or reward referrals of items or services reimbursable by a Federal health care program

Prohibits physicians from referring Medicare patients to an entity with which the physician or physician's immediate family member has a financial relationship

Prohibits any person from knowingly presenting or causing fraudulent claim for payment

False Claims Act

Anti-Kickback Statute

Self-Referral Prohibition Statute

Prohibits physicians from referring Medicare patients to an entity with which the physician or physician's immediate family member has a financial relationship

Prohibits any person from knowingly presenting or causing fraudulent claim for payment

False Claims Act

Anti-Kickback Statute

Self-Referral Prohibition Statute

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