PCE Industry Regulations 4

Question 1

An Advance Beneficiary Notice (ABN) is used in Medicare billing primarily to:

Accepted Answer

Notify a patient that Medicare may not cover a service so they can decide whether to proceed

Answer

An ABN informs a Medicare beneficiary that a specific service may not be covered, allowing them to choose whether to receive it and accept financial responsibility.

Question 2

The False Claims Act imposes civil liability on those who:

Accepted Answer

Knowingly submit false or fraudulent claims for payment to the federal government

Answer

The False Claims Act targets knowing and intentional submission of fraudulent claims to federal healthcare programs such as Medicare and Medicaid.

Question 3

Regarding supervision requirements for physical therapist assistants (PTAs), which statement is MOST accurate?

Accepted Answer

Supervision requirements vary by state law but generally require the PT to be available and to periodically assess the patient

Answer

PTA supervision is primarily governed by state practice acts, but the supervising PT retains responsibility for patient care regardless of delegation.

Question 4

A physiotherapy clinic manager notices the schedule shows a therapist is double-booked and billing simultaneously for two patients in separate rooms. This practice is BEST described as:

Accepted Answer

Concurrent billing fraud if both patients are billed as if receiving one-on-one care

Answer

Billing for individual one-on-one time while the therapist is simultaneously treating another patient constitutes fraudulent billing under Medicare.

Question 5

Which regulatory body is responsible for investigating complaints of unprofessional conduct against licensed physical therapists in a US state?

Accepted Answer

The state physical therapy licensing board

Answer

State licensing boards have the authority to investigate complaints, impose sanctions, and revoke licensure for unprofessional conduct.

(PCE) Physiotherapy Competency Exam Practice Test

(PCE) Physiotherapy Competency Exam Practice Test

PCE Industry Regulations 4