Which established the CERT, FATHOM, HPMP, PEPPER, and PERM programs?
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
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Q. 2) The Recovery Audit Contractor (RAC) program was developed to identify and reduce improper
payments for
A. Medicaid claims.
B. Medicare claims.
C. both Medicare claims and collection of overpayments.
D. collection of overpayments.
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Q. 3) Which authorizes CMS to enter into contracts with entities to perform cost report auditing, medical review, anti-fraud activities, and the Medicare Secondary Payer (MSP) program?
a. COBRA
b. MIP
c. PEPP
d. TEFRA
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Q. 4) Which of the following would not be an example of a secondary data source?
A. disease index. C. MPI.
B. accession register. D. hospital census.
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Q. 5) Which consists of audits implemented by DHHS that examines the billing practices of physicians at teaching hospitals with the focus on compliance with the Medicare rule affecting payment for physician services provided by residents and whether the level of the physician service was coded and billed properly?
a. NCCI
b. PATH
c. SCHIP
d. ZPIC
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Q. 6) To enter the results of a CBC into the computer system, you would use a(n)
A. laboratory system. C. pharmacy system.
B. radiology system. D. order entry/results reporting system.
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Q. 7) Which is the physician self-referral law that protects patients and federal health care programs from fraud and abuse by curtailing the corrupting influence of money on health care decisions?
a. Federal Anti-Kickback Law
b. Federal Claims Collection Act
c. Occupational Safety and Health Act
d. Social Security Act
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Q. 8) You recommend that the staff at your home health agency routinely check to verify that a
summary on each patient is provided to the attending physician so that he or she can review,
update, and recertify the patient as appropriate. The time frame for requiring this summary is at
least every
A. week. C. 60 days.
B. month. D. 90 days.
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Q. 9) Which prohibits physicians from referring Medicare patients to clinical laboratory services in which the physicians or their family members have a financial ownership/investment interest and/or compensation arrangement?
a. False Claims Act
b. Federal Claims Collection Act
c. Privacy Act of 1974
d. Stark I
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Q. 10) The federally mandated resident assessment instrument used in long-term care facilities consists
of three basic components, including the new care area assessment, utilization guidelines, and the
A. UHDDS. C. OASIS.
B. MDS. D. DEEDS.
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