FRAUD WASTE AND ABUSE PREPARATION
TEST 2026 QUESTIONS AND CORRECT
ANSWERS GRADED A+
● You are performing a regular inventory of the controlled substances in
the pharmacy. You discover a minor inventory discrepancy. What should
you do? Answer: Follow your pharmacy's procedures.
● Which of the following requires intent to obtain payment and the
knowledge the actions are wrong? Answer: Fraud
● A person drops 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 possible forgery. What
is your next step? Answer: Call the prescriber to verify the quantity
● You are in charge of paying claims submitted by providers. You notice
a certain diagnostic provider ("Doe Diagnostics") requested a substantial
payment for a large patient group. Many of these claims are for a certain
procedure. You review the same type of procedure for other diagnostic
providers and realize Doe Diagnostics' claims far exceed any other
provider you reviewed. What should you do? Answer: Consult with your
immediate supervisor for next steps or contact the compliance
department (via compliance hotline, Special Investigations Unit [SIU],
or other mechanism)
TEST 2026 QUESTIONS AND CORRECT
ANSWERS GRADED A+
● You are performing a regular inventory of the controlled substances in
the pharmacy. You discover a minor inventory discrepancy. What should
you do? Answer: Follow your pharmacy's procedures.
● Which of the following requires intent to obtain payment and the
knowledge the actions are wrong? Answer: Fraud
● A person drops 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 possible forgery. What
is your next step? Answer: Call the prescriber to verify the quantity
● You are in charge of paying claims submitted by providers. You notice
a certain diagnostic provider ("Doe Diagnostics") requested a substantial
payment for a large patient group. Many of these claims are for a certain
procedure. You review the same type of procedure for other diagnostic
providers and realize Doe Diagnostics' claims far exceed any other
provider you reviewed. What should you do? Answer: Consult with your
immediate supervisor for next steps or contact the compliance
department (via compliance hotline, Special Investigations Unit [SIU],
or other mechanism)
