AHIP– MEDICARE FRAUD, WASTE, & ABUSE (FWA) FINAL
EXAM QUESTIONS COMPLETE WITH 100% VERIFIED
ANSWERS
1. Ways to report potential fraud, waste, and abuse (FWA) include:
a) Telephone hotlines only
b) Mail drops only
c) In-person reporting only
d) Telephone hotlines, mail drops, in-person reporting, and reporting to
Special Investigative Units (SIUs)
Correct Answer: d
2. Waste includes any misuse of resources, such as the overuse of
services or other practices that directly or indirectly result in
unnecessary costs to the Medicare Program.
a) True
b) False
Correct Answer: a (True)
3. Abuse involves payment for items or services when there is no legal
entitlement to that payment and the provider has not knowingly or
intentionally misrepresented facts to obtain payment.
,a) True
b) False
Correct Answer: a (True)
4. What are some of the penalties for violating fraud, waste, and
abuse (FWA) laws?
a) Civil Monetary Penalties only
b) Imprisonment only
c) Exclusion from participation in all Federal health care programs only
d) Civil Monetary Penalties, imprisonment, and exclusion from all
Federal health care programs
Correct Answer: d
5. Bribes or kickbacks of any kind for services that are paid under a
Federal health care program (which includes Medicare) constitute
fraud by the person making as well as the person receiving them.
a) True
b) False
Correct Answer: a (True)
6. You can help prevent fraud, waste, and abuse (FWA) by doing all the
following: look for suspicious activity; conduct yourself in an ethical
manner; ensure accurate and timely data and billing; ensure you
coordinate with other payers; keep up to date with FWA policies and
procedures, standards of conduct, laws, regulations, and CMS
, guidance; verify all information provided to you.
a) True
b) False
Correct Answer: a (True)
7. Some of the laws governing Medicare Part C and D fraud, waste,
and abuse (FWA) include the Health Insurance Portability and
Accountability Act (HIPAA), the Civil False Claims Act, the Anti-
Kickback Statute, and the Criminal Health Care Fraud Statute.
a) True
b) False
Correct Answer: a (True)
8. Once a corrective action plan is started, the corrective action plan
must be monitored annually to ensure they are effective.
a) True
b) False
Correct Answer: b (False) – Monitoring should be ongoing, not just
annually.
9. 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.
a) True
b) False
EXAM QUESTIONS COMPLETE WITH 100% VERIFIED
ANSWERS
1. Ways to report potential fraud, waste, and abuse (FWA) include:
a) Telephone hotlines only
b) Mail drops only
c) In-person reporting only
d) Telephone hotlines, mail drops, in-person reporting, and reporting to
Special Investigative Units (SIUs)
Correct Answer: d
2. Waste includes any misuse of resources, such as the overuse of
services or other practices that directly or indirectly result in
unnecessary costs to the Medicare Program.
a) True
b) False
Correct Answer: a (True)
3. Abuse involves payment for items or services when there is no legal
entitlement to that payment and the provider has not knowingly or
intentionally misrepresented facts to obtain payment.
,a) True
b) False
Correct Answer: a (True)
4. What are some of the penalties for violating fraud, waste, and
abuse (FWA) laws?
a) Civil Monetary Penalties only
b) Imprisonment only
c) Exclusion from participation in all Federal health care programs only
d) Civil Monetary Penalties, imprisonment, and exclusion from all
Federal health care programs
Correct Answer: d
5. Bribes or kickbacks of any kind for services that are paid under a
Federal health care program (which includes Medicare) constitute
fraud by the person making as well as the person receiving them.
a) True
b) False
Correct Answer: a (True)
6. You can help prevent fraud, waste, and abuse (FWA) by doing all the
following: look for suspicious activity; conduct yourself in an ethical
manner; ensure accurate and timely data and billing; ensure you
coordinate with other payers; keep up to date with FWA policies and
procedures, standards of conduct, laws, regulations, and CMS
, guidance; verify all information provided to you.
a) True
b) False
Correct Answer: a (True)
7. Some of the laws governing Medicare Part C and D fraud, waste,
and abuse (FWA) include the Health Insurance Portability and
Accountability Act (HIPAA), the Civil False Claims Act, the Anti-
Kickback Statute, and the Criminal Health Care Fraud Statute.
a) True
b) False
Correct Answer: a (True)
8. Once a corrective action plan is started, the corrective action plan
must be monitored annually to ensure they are effective.
a) True
b) False
Correct Answer: b (False) – Monitoring should be ongoing, not just
annually.
9. 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.
a) True
b) False
