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Questions and Answers
Which of the following are ways to report potential Fraud, Waste, and Abuse (FWA)? (Select all that apply)
Once a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective.
True
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.
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.
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Bribes or kickbacks of any kind for services that are paid under a Federal health care program constitute fraud by the person making as well as the person receiving them.
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Waste includes any misuse of resources such as the overuse of services, or other practices that result in unnecessary costs to the Medicare Program.
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Study Notes
Reporting Fraud, Waste, and Abuse (FWA)
- Potential FWA can be reported through multiple channels: telephone hotlines, mail drops, in-person reporting, and Special Investigations Units (SIUs).
- All of the above methods are valid for reporting FWA concerns.
Corrective Actions Monitoring
- Once initiated, corrective action plans must be monitored annually to ensure effectiveness.
- A true/false question underscores the importance of annual monitoring.
Liabilities for False Claims
- Individuals who knowingly submit false claims to the Government can face severe penalties.
- The penalty includes liability for five times the damages caused to the Government, emphasizing the seriousness of false claims.
Compliance Department Reports
- Issues to report to the Compliance Department include suspected FWA, potential health privacy violations, and unethical behavior or misconduct.
- True/false format highlights the necessity of reporting such issues.
Bribery and Kickbacks as Fraud
- Engaging in bribes or kickbacks related to services under Federal health care programs, such as Medicare, is classified as fraud.
- This applies to both the giver and receiver of such improper payments.
Definition of Waste
- Waste refers to the misuse of resources, such as overusing services, leading to unnecessary costs for the Medicare Program.
- Recognizing waste is crucial for maintaining the efficiency of healthcare programs.
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Description
Test your knowledge on Fraud, Waste, and Abuse with these flashcards. Learn about reporting methods and the importance of monitoring corrective actions. Perfect for compliance training or general awareness.
