IHSS - In-Home Supportive Services certified provider Fraud Prevention and Reporting Questions and Answers

Question 1

An IHSS provider, Mark, is asked by his recipient to sign a timesheet for the entire pay period on the first day, with the promise that the recipient will 'let him know' if any days are missed.
What is the most appropriate and compliant action for Mark to take?

Accepted Answer

Refuse to sign the timesheet until all the hours for the pay period have been actually worked.

Answer

Sign the timesheet as requested to maintain a good relationship with the recipient.

Answer

Sign the timesheet but keep a separate, personal log of hours worked to submit later if there's a discrepancy.

Answer

Ask the recipient to initial each day on the timesheet in advance to confirm the planned hours.

Question 2

A provider suspects that a recipient is exaggerating their needs to the county social worker to receive more authorized hours than necessary. Which of the following is the provider's responsibility regarding potential fraud?

Accepted Answer

Report their concerns about potential fraud to the appropriate IHSS fraud hotline or county office.

Answer

Confront the recipient directly and demand they correct the information with the social worker.

Answer

Continue working the authorized hours, as it is the social worker's job, not the provider's, to assess needs.

Answer

Adjust the timesheet to reflect the hours they believe are actually needed, regardless of what is authorized.

Question 3

What is the primary purpose of the IHSS Quality Assurance (QA) program activities, such as unannounced home visits and desk reviews?

Accepted Answer

To enhance program integrity, verify services are being delivered as authorized, and prevent fraud.

Answer

To find reasons to reduce a recipient's total number of authorized service hours.

Answer

To exclusively monitor the provider's job performance and adherence to the work schedule.

Answer

To provide additional training and certification opportunities for providers during the visit.

Question 4

A provider is hired to care for a recipient. The recipient's son, who is not an authorized provider, performs the care duties for a week while the main provider is on vacation. The son asks the main provider to submit a timesheet for that week and then pay him in cash. This practice is known as:

Accepted Answer

Subcontracting

Answer

Check Splitting

Answer

Timesheet Forging

Answer

Authorized Delegation

Question 5

Which of the following actions constitutes timesheet fraud?

Accepted Answer

Claiming hours for domestic services while the recipient is temporarily in a skilled nursing facility.

Answer

Reporting the exact number of hours worked each day, even if it varies.

Answer

Submitting a timesheet on the last day of the pay period after all work is completed.

Answer

Discussing a discrepancy in remembered hours with the recipient before submitting the timesheet.

Question 6

If an IHSS provider is convicted of fraud against a government health care program, what is the consequence for their eligibility to be an IHSS provider?

Accepted Answer

They are ineligible to be an IHSS provider for 10 years following the conviction.

Answer

They must complete a fraud prevention course to be recertified.

Answer

They are permanently banned from ever being an IHSS provider.

Answer

Their eligibility is suspended for 1 year and they are subject to random audits.