5 sample questions with instant feedback and answer explanations. See how ready you are.
Question 1
What federal law prohibits physicians from referring Medicare or Medicaid patients to entities with which they have a financial relationship?
Answer: The Stark Law (Physician Self-Referral Law). It is a strict liability statute, meaning intent does not need to be proven to establish a violation.
Question 2
Under the False Claims Act, what is the term for a private individual who files a lawsuit on behalf of the government against a fraudulent party?
Answer: A relator. This type of lawsuit is called a qui tam action, and the relator may receive a portion of any recovered funds.
Question 3
What is the key distinction between healthcare fraud and healthcare abuse?
Answer: Fraud involves intentional deception or misrepresentation to obtain an unauthorized benefit. Abuse involves practices inconsistent with sound fiscal, business, or medical practices but without proven fraudulent intent.
Question 4
What federal law makes it illegal to offer, pay, solicit, or receive anything of value to induce or reward referrals of federal healthcare program business?
Answer: The Anti-Kickback Statute (AKS). Violations are considered criminal offenses and can result in exclusion from federal healthcare programs.
Question 5
Which law allows the government to impose civil monetary penalties on individuals or entities that submit false claims to federal healthcare programs, even without criminal prosecution?
Answer: The Civil Monetary Penalties Law (CMPL). Penalties can include fines per false claim and exclusion from federal healthcare programs.