Certification Exam: Fraud, Waste and Abuse (FWA) & Medicare Compliance

Question 1 of 10

What primarily distinguishes fraud from waste?

A) Waste is always criminal B) Fraud applies only to physicians C) The dollar amount involved D) Fraud requires knowledge and intent; waste generally does not

Question 2 of 10

Billing a higher-level service than the one documented and performed is called what?

A) Bundling B) Unbundling C) Waste D) Upcoding

Question 3 of 10

How does the Stark Law differ from the Anti-Kickback Statute?

A) Stark has no financial penalties B) Stark is a strict liability statute; intent is not required C) Stark requires proof of criminal intent D) Stark applies only to Medicaid

Question 4 of 10

Your organisation discovers it was overpaid by Medicare due to an innocent billing error. What is required?

A) Report and return the overpayment B) Wait until Medicare requests it back C) Offset it against future underpayments D) Nothing, because the error was unintentional

Question 5 of 10

An employee reports a suspected false claim in good faith and is then demoted. What protection applies?

A) None, because the report was only a suspicion B) Protection only for licensed clinical staff C) False Claims Act anti-retaliation protection, with remedies including reinstatement and double back pay D) Protection only if the allegation is proven in court

Question 6 of 10

Under the False Claims Act, what does 'knowingly' include?

A) Only actual knowledge that a claim is false B) Only conduct proven to be intentional fraud C) Only conduct admitted in writing D) Actual knowledge, deliberate ignorance, and reckless disregard

Question 7 of 10

How often does OIG guidance recommend screening staff against the exclusion lists?

A) Annually B) Once at hire C) Only when contracts renew D) Monthly

Question 8 of 10

Which is one of the seven elements of an effective compliance program?

A) A requirement that all reports be made in writing to a supervisor B) Annual salary review for the compliance officer C) A marketing plan for compliance services D) Effective lines of communication, including a way to report anonymously

Question 9 of 10

Which statement about the Anti-Kickback Statute is correct?

A) It requires proof that a patient was harmed B) It applies only to hospitals C) Remuneration means anything of value, and an arrangement can violate it if even one purpose is to induce referrals D) It applies only to cash payments

Question 10 of 10

How often must FWA and general compliance training be completed under CMS requirements?

A) Only when an audit is announced B) Within 90 days of hire and at least annually thereafter C) Every two years D) Once at hire only