The False Claim Act prohibits a person submitting a false or fraudulent claim to which of the following?
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The federal government
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A health insurance company
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A patient
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Anyone
In which of the following legal actions does the person reporting violations of law get to share in the
amount of money recovered by the lawsuit?
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Felonies
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Healthcare Fraud
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Qui tam
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Sua Sponte
Under the Anti-Kickback Law (or AKS for anti-kickback statute) when is it unlawful for a physician to make
referrals?
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When the receiving physician is a close friend or family member
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When the receiving physician is not registered with CMS
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When the receiving physician pays something for the referral
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Anytime
Under the Stark Law, physicians cannot refer patient using certain federal program services to whom?
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Themselves
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Immediate family
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Companies in which they have a financial interest
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Any of these
Which of the following agencies coordinate and oversee health care fraud enforcement?
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Federal Trade Commission
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Health Care Fraud Administration
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Congressional Budget Office
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Office of the Inspector General
Choose the correct underlined answer
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In order to be found guilty of violating the Anti-Kickback Statue, the government would have to
prove/have not to prove? that you intended to violate the law.
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In order to be found guilty of violating the Stark Law, the government would have to prove/ have
not to prove? that you intended to violate the law.
Is this fraud? Yes or No
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A patient is prescribed medication to be taken once per day (30 doses in one month). The
provider sends the order to the pharmacy for 90 doses with instructions printed to "take one pill 3
times per day". The provider tells the patient to ignore the label and only take one per day.
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During a routine visit, a primary care physician reviews a patient's lab results that are cause for
concern. She immediately arranges a same-day consult with a specialist and transportation
directly to the specialty practice. As soon as the patient arrives - lab results in hand and less than
two hours old - the specialist orders collection and analysis of all the same lab work to be
repeated (and billed for) by his own staff.
