HEALTH LAW #12 EXAM QUESTIONS
WITH COMPLETE ANSWERS
A physician would be found guilty of violating the Anti-Kickback Statute only if it
resulted in Medicare or Medicaid being billed for services that either were not
properly rendered or were not medically necessary - ANSWER-False
Which of the following is NOT one of the listed "designated health services" under
the Stark law? - ANSWER-mental health services
In some situations, the federal government has taken the position that providing poor
quality of care may constitute fraud and abuse. - ANSWER-True
Which of the following best summarizes the "Special Fraud Alert" reprinted in the
assigned reading from the textbook? - ANSWER-Various fraudulent schemes by
which Medicare and Medicaid were inappropriately billed for services purportedly
provided to nursing facility residents.
If a physician invests in an imaging center, in order for the physician to refer
Medicaid or Medicare patients to the imaging center without violating the Stark Law,
which one of the following is required: - ANSWER-The financial relationship between
the physician and the imaging center must fit within an exception to the Stark law.
Empirical research has demonstrated that no physicians think that making false
statements about a patient's condition to third-party payors, such as managed care
organizations, is justifiable in order for the patient to obtain services the patient
needs and could not otherwise afford. - ANSWER-False
Under the Physician Self-Referral Law ("Stark Law"), a violation occurs only if the
party has the intent to defraud the government by referring a patient to receive
unnecessary lab work. - ANSWER-False
According to the Department of Health and Human Service, Office of the Inspector
General (OIG), proper documentation in a patient's medical records and in billing
claims is important for three main reasons. What are these three reasons? -
ANSWER-protection of the federal programs, protection of providers, and protection
of patients
Under the federal civil False Claims Act, which of the following is NOT one of the
statute's definitions of the terms "knowing" and "knowingly": - ANSWER-a signed
acknowledgment that the provider was aware of and understood the applicable
reimbursement rules.
In a civil case brought under the federal False Claims Act, the government must
prove beyond a reasonable doubt that the defendant knowingly and willfully made
false statements for payment under a federal health care program. - ANSWER-False
WITH COMPLETE ANSWERS
A physician would be found guilty of violating the Anti-Kickback Statute only if it
resulted in Medicare or Medicaid being billed for services that either were not
properly rendered or were not medically necessary - ANSWER-False
Which of the following is NOT one of the listed "designated health services" under
the Stark law? - ANSWER-mental health services
In some situations, the federal government has taken the position that providing poor
quality of care may constitute fraud and abuse. - ANSWER-True
Which of the following best summarizes the "Special Fraud Alert" reprinted in the
assigned reading from the textbook? - ANSWER-Various fraudulent schemes by
which Medicare and Medicaid were inappropriately billed for services purportedly
provided to nursing facility residents.
If a physician invests in an imaging center, in order for the physician to refer
Medicaid or Medicare patients to the imaging center without violating the Stark Law,
which one of the following is required: - ANSWER-The financial relationship between
the physician and the imaging center must fit within an exception to the Stark law.
Empirical research has demonstrated that no physicians think that making false
statements about a patient's condition to third-party payors, such as managed care
organizations, is justifiable in order for the patient to obtain services the patient
needs and could not otherwise afford. - ANSWER-False
Under the Physician Self-Referral Law ("Stark Law"), a violation occurs only if the
party has the intent to defraud the government by referring a patient to receive
unnecessary lab work. - ANSWER-False
According to the Department of Health and Human Service, Office of the Inspector
General (OIG), proper documentation in a patient's medical records and in billing
claims is important for three main reasons. What are these three reasons? -
ANSWER-protection of the federal programs, protection of providers, and protection
of patients
Under the federal civil False Claims Act, which of the following is NOT one of the
statute's definitions of the terms "knowing" and "knowingly": - ANSWER-a signed
acknowledgment that the provider was aware of and understood the applicable
reimbursement rules.
In a civil case brought under the federal False Claims Act, the government must
prove beyond a reasonable doubt that the defendant knowingly and willfully made
false statements for payment under a federal health care program. - ANSWER-False
