Microsoft Word - HW_4.docx
HW 4
Indicate the answer choice that best completes the statement or answers the question.
1. Which program measures improper payments in the Medicaid program and the State Children’s Health Insurance
Program (SCHIP)?
a. CERT
b. FATHOM
c. HPMP
d. PERM
2. Which unique identifier is assigned to third-party payers and has 10 numeric positions, including a check digit as the
tenth position?
a. HPID
b. PAYERID
c. PlanID
d. UPIN
3. Which of the following is an example of fraud?
a. billing noncovered services as covered services
b. falsifying certificates of medical necessity plans of treatment
c. reporting duplicative charges on an insurance claim
d. submitting claims for services not medically necessary
4. Which is testimony under oath taken outside of court, such as at the physician’s
office? a. deposition
b. interrogatory
c. subpoena
d. subpoena duces tecum
5. Which program assesses and measures improper Medicare fee-for-service payments (based on reviewing selected
claims and associated medical record documentation)?
a. CERT
b. FATHOM
c. HPMP
d. PERM
6. Which amended Title IX of the Public Health Service Act to encourage voluntary and confidential reporting of
events that adversely affect patients, creating organizations that collect, aggregate, and analyze confidential
information reported by health care providers?
a. Deficit Reduction Act of 2005
b. Improper Payments Information Act of 2002
c. Patient Safety and Quality Improvement Act of 2005
d. Tax Relief and Health Care Act of 2006
, Microsoft Word - HW_4.docx
7. Which program was implemented to find and correct improper Medicare payments paid to health care providers
participating in fee-for-service Medicare?
a. Hospital Inpatient Quality Reporting (Hospital IQR)
b. Medicaid Integrity Program (MIP)
c. Recovery Audit Contractor (RAC)
d. Zone Program Integrity Contractor (ZPIC)
8. Which is the official document that contains new and changed Medicare policies and/or procedures that are to be
incorporated into a specific CMS program manual?
a. bulletins
b. companion guides
c. face sheets
d. transmittals
9. Which program measures, monitors, and reduces the incidence of Medicare fee-for-service payment errors for
shortterm, acute care, inpatient PPS hospitals?
a. CERT
b. FATHOM
c. HPMP
d. PERM
10. HIPAA defines fraud as an deception or misrepresentation that someone makes, knowing it is false, that
could result in an unauthorized payment.
a. accidental
b. intentional
11. Which increased resources available to CMS to combat abuse, fraud, and waste in the Medicaid program, creating
the Medicare Improvement Program (MIP)?
a. Deficit Reduction Act of 2005
b. Improper Payments Information Act of 2002
c. Patient Safety and Quality Improvement Act of 2005
d. Tax Relief and Health Care Act of 2006
12. The Medicare Integrity Program includes medical review, which is defined by CMS as a review of claims to
determine whether services provided are , as well as to followup on the effectiveness of previous
corrective actions.
a. affordable by patient populations
b. covered by the Medicare program
c. effective for treatment of conditions
d. medically reasonable and necessary
HW 4
Indicate the answer choice that best completes the statement or answers the question.
1. Which program measures improper payments in the Medicaid program and the State Children’s Health Insurance
Program (SCHIP)?
a. CERT
b. FATHOM
c. HPMP
d. PERM
2. Which unique identifier is assigned to third-party payers and has 10 numeric positions, including a check digit as the
tenth position?
a. HPID
b. PAYERID
c. PlanID
d. UPIN
3. Which of the following is an example of fraud?
a. billing noncovered services as covered services
b. falsifying certificates of medical necessity plans of treatment
c. reporting duplicative charges on an insurance claim
d. submitting claims for services not medically necessary
4. Which is testimony under oath taken outside of court, such as at the physician’s
office? a. deposition
b. interrogatory
c. subpoena
d. subpoena duces tecum
5. Which program assesses and measures improper Medicare fee-for-service payments (based on reviewing selected
claims and associated medical record documentation)?
a. CERT
b. FATHOM
c. HPMP
d. PERM
6. Which amended Title IX of the Public Health Service Act to encourage voluntary and confidential reporting of
events that adversely affect patients, creating organizations that collect, aggregate, and analyze confidential
information reported by health care providers?
a. Deficit Reduction Act of 2005
b. Improper Payments Information Act of 2002
c. Patient Safety and Quality Improvement Act of 2005
d. Tax Relief and Health Care Act of 2006
, Microsoft Word - HW_4.docx
7. Which program was implemented to find and correct improper Medicare payments paid to health care providers
participating in fee-for-service Medicare?
a. Hospital Inpatient Quality Reporting (Hospital IQR)
b. Medicaid Integrity Program (MIP)
c. Recovery Audit Contractor (RAC)
d. Zone Program Integrity Contractor (ZPIC)
8. Which is the official document that contains new and changed Medicare policies and/or procedures that are to be
incorporated into a specific CMS program manual?
a. bulletins
b. companion guides
c. face sheets
d. transmittals
9. Which program measures, monitors, and reduces the incidence of Medicare fee-for-service payment errors for
shortterm, acute care, inpatient PPS hospitals?
a. CERT
b. FATHOM
c. HPMP
d. PERM
10. HIPAA defines fraud as an deception or misrepresentation that someone makes, knowing it is false, that
could result in an unauthorized payment.
a. accidental
b. intentional
11. Which increased resources available to CMS to combat abuse, fraud, and waste in the Medicaid program, creating
the Medicare Improvement Program (MIP)?
a. Deficit Reduction Act of 2005
b. Improper Payments Information Act of 2002
c. Patient Safety and Quality Improvement Act of 2005
d. Tax Relief and Health Care Act of 2006
12. The Medicare Integrity Program includes medical review, which is defined by CMS as a review of claims to
determine whether services provided are , as well as to followup on the effectiveness of previous
corrective actions.
a. affordable by patient populations
b. covered by the Medicare program
c. effective for treatment of conditions
d. medically reasonable and necessary
