Chapter 16 Quiz

Question 1

An example of a Stark Law violation is:

Answer 1

Paying a physician for a referral

Question 2

EMTALA:

Answer 2

• Requires all Medicare and Medicaid hospitals to provide an appropriate screening
• Requires private, for-profit hospitals to provide patients an appropriate screening
• Mandates that no patient should be billed for services if they can’t pay

Question 3

Examples of health care fraud and abuse include:

Answer 3

• Claims do not meet medical necessity
• Duplicate billing
• Upcoding of services
• Kickbacks for referrals

Question 4

The investigative and enforcement authority to deal with fraud and abuse violations was granted to the Department of Health and Human Services (DHHS) through:

Answer 4

Operation Restore Trust

Question 5

The qui tam provision offers individuals:

Answer 5

• Protection for coming forward against their organization or employer
• Monetary incentives
• Shelter from prosecution in many instances

Question 6

Violations of the Emergency Medical Treatment and Active Labor Act (EMTALA) include all of the following, except:

Answer 6

Completing a Medical Screening exam and stabilizing the patient

Question 7

HEAT is the President’s newest tool against:

Answer 7

Fraud and abuse concerning Medicare and Medicaid claims

Question 8

True or False? Fraud is an improper act that is unintentional and inconsistent with standard practices.

Answer 8

False

Question 9

True or False? The Office of Inspector General of the DHHS (OIG-DHHS) reported that tens of billions of dollars were lost to fraud and abuse in 2010.

Answer 9

True

Question 10

True or False? The Sherman Anti Trust Act prohibits mergers and acquisitions that lessen competition.

Answer 10

False