CHC Healthcare Fraud and Abuse 2

Question 1

Under the Stark Law, which of the following is a permissible financial relationship between a physician and a designated health service (DHS) entity?

Accepted Answer

A compensation arrangement that meets the fair market value exception

Answer

Stark Law allows financial relationships if they meet specific statutory exceptions, including the fair market value compensation exception.

Question 2

Which federal agency primarily investigates and prosecutes healthcare fraud under the False Claims Act?

Accepted Answer

The Department of Justice (DOJ)

Answer

The Department of Justice prosecutes False Claims Act cases, though the OIG investigates and the DOJ litigates civil and criminal FCA violations.

Question 3

A hospital discovers that a physician has been receiving free office space from the hospital in exchange for referrals. This most likely violates which law?

Accepted Answer

Anti-Kickback Statute

Answer

Receiving free office space in exchange for referrals constitutes remuneration linked to referral volume, which violates the Anti-Kickback Statute.

Question 4

Which element distinguishes 'fraud' from 'abuse' in healthcare compliance?

Accepted Answer

The intentional, knowing, or reckless nature of the conduct

Answer

Fraud requires intentional or knowing deception, whereas abuse involves practices that are inconsistent with sound fiscal, business, or medical practices but may lack specific intent.

Question 5

Under the False Claims Act, what is the minimum per-claim civil penalty range (approximately) for a false claim submitted to the government?

Accepted Answer

$13,000 to $27,000

Answer

FCA civil penalties are adjusted annually for inflation; as of recent updates, the per-claim penalty range is approximately $13,000 to $27,000 per false claim.

CHC - Certified in Healthcare Compliance Practice Test

CHC - Certified in Healthcare Compliance Practice Test

CHC Healthcare Fraud and Abuse 2