1
, CPMA EXAM NEWEST 2026 PACKAGE DEAL|
DIFFERENT VERSIONS WITH COMPLETE 800 REAL
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+| CPMA
FINAL EXAM PREP 2026/2027 (BRAND NEW!!)
1. What is the difference between fraud and abuse according
to CMS definitions?
A. Fraud involves unintentional errors; abuse involves intentional
deception
B. Fraud involves knowingly misrepresenting facts to obtain
payment; abuse results in unnecessary costs without intent
C. There is no legal difference; the terms are interchangeable
D. Fraud applies only to Medicare; abuse applies only to
Medicaid
2
,Answer: B – Fraud involves knowingly misrepresenting facts
to obtain payment; abuse results in unnecessary costs without
intent
Rationale: CMS defines fraud as making false statements or
misrepresenting facts knowingly to obtain an undeserved benefit.
Abuse is defined as actions that result in unnecessary costs to a
federal healthcare program, either directly or indirectly, without the
knowledge/intent element of fraud .
2. Which of the following is an example of CMS-defined
fraud?
A. Misusing codes on a claim
B. Billing for services not medically necessary
C. Billing for services that were not furnished
D. Failure to maintain adequate medical records
Answer: C – Billing for services that were not furnished
Rationale: CMS examples of fraud include billing for
3
, services/supplies known not to be furnished, altering claim forms for
k k k k k k k k k
higher payment, billing for higher level services than provided, and
k k k k k k k k k k
k misrepresenting diagnoses. Misusing codes, unnecessary
k k k k
services, and poor records constitute abuse, not fraud .
k k k k k k k k
3. What is the penalty range under the current False Claims Act
k k k k k k k k k k
k (FCA) per false claim?
k k k
A. 1,000–5,000
B. 5,500–11,000
C. 10,000–20,000
D. 50,000–100,000
Answer: B – 5,500–11,000 per claim
k k k k k
Rationale: The False Claims Act imposes penalties ranging
k k k k k k k
from 5,500𝑡𝑜11,000 per false claim, plus treble damages (three times
k k k k k k k k k
k the amount of damages sustained). These penalties are adjusted
k k k k k k k k
k periodically for inflation . k k k
4
, CPMA EXAM NEWEST 2026 PACKAGE DEAL|
DIFFERENT VERSIONS WITH COMPLETE 800 REAL
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+| CPMA
FINAL EXAM PREP 2026/2027 (BRAND NEW!!)
1. What is the difference between fraud and abuse according
to CMS definitions?
A. Fraud involves unintentional errors; abuse involves intentional
deception
B. Fraud involves knowingly misrepresenting facts to obtain
payment; abuse results in unnecessary costs without intent
C. There is no legal difference; the terms are interchangeable
D. Fraud applies only to Medicare; abuse applies only to
Medicaid
2
,Answer: B – Fraud involves knowingly misrepresenting facts
to obtain payment; abuse results in unnecessary costs without
intent
Rationale: CMS defines fraud as making false statements or
misrepresenting facts knowingly to obtain an undeserved benefit.
Abuse is defined as actions that result in unnecessary costs to a
federal healthcare program, either directly or indirectly, without the
knowledge/intent element of fraud .
2. Which of the following is an example of CMS-defined
fraud?
A. Misusing codes on a claim
B. Billing for services not medically necessary
C. Billing for services that were not furnished
D. Failure to maintain adequate medical records
Answer: C – Billing for services that were not furnished
Rationale: CMS examples of fraud include billing for
3
, services/supplies known not to be furnished, altering claim forms for
k k k k k k k k k
higher payment, billing for higher level services than provided, and
k k k k k k k k k k
k misrepresenting diagnoses. Misusing codes, unnecessary
k k k k
services, and poor records constitute abuse, not fraud .
k k k k k k k k
3. What is the penalty range under the current False Claims Act
k k k k k k k k k k
k (FCA) per false claim?
k k k
A. 1,000–5,000
B. 5,500–11,000
C. 10,000–20,000
D. 50,000–100,000
Answer: B – 5,500–11,000 per claim
k k k k k
Rationale: The False Claims Act imposes penalties ranging
k k k k k k k
from 5,500𝑡𝑜11,000 per false claim, plus treble damages (three times
k k k k k k k k k
k the amount of damages sustained). These penalties are adjusted
k k k k k k k k
k periodically for inflation . k k k
4
