AHIP 2024 FRAUD FINAL EXAM QUESTIONS WITH CORRECT ANSWERS 2025

AHIP 2024 FRAUD FINAL EXAM
QUESTIONS WITH CORRECT
ANSWERS 2025/2026
Waste includes any misuse of resources, such as the overuse of services or other practices that
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directly or indirectly result in unnecessary
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costs to the Medicare Program. - correct answersTrue
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Once a corrective action plan is started, the corrective action plan must be monitored annually
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to ensure they are effective. - correct answersFalse
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These are examples of issues that should be reported to a Compliance Department: suspected f
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raud, waste, and abuse (FWA); potential
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health privacy violation, unethical behavior, and employee misconduct. - correct answersTrue
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What are some of the penalties for violating fraud, waste, and abuse (FWA) laws? -
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correct answersAll of the above
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Some of the laws governing Medicare Part C and D fraud, waste, and abuse (FWA) include the H
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ealth Insurance Portability and
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Accountability Act (HIPAA), the Civil False Claims Act, the Anti- A A A A A A A A A




Kickback Statute, and the Criminal Health Care Fraud Statute. - correct answersTrue
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Any person who knowingly submits false claims to the Government is liable for five times the G
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overnment's damages caused by the A A A A




violator plus a penalty. - correct answersFalse
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Ways to report potential fraud, waste, and abuse (FWA) include: -
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correct answersAll of the above
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You can help prevent fraud, waste, and abuse (FWA) by doing all the following:
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Look for suspicious activity
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Conduct yourself in an ethical manner A A A A A




Ensure accurate and timely data and billing
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Ensure you coordinate with other payers
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Keep up to date with FWA policies and procedures, standards of conduct, laws, regulations, and
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the Centers for Medicare & Medicaid
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Services (CMS) guidance A A