Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
2017 CMS FWA Training
1. Combating Medicare Parts C and D FWA Training
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.6 Why Do I Need Training?
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.7 Training Requirements
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.8 Learn More about Medicare Part C & D
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.9 FWA Training Requirements Exception
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.18 Differences Among Fraud, Waste, and Abuse
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.20 Civil False Claims Act (FCA)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.21 Civil False Claims Act (FCA) continued
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.22 Civil False Claims Act (FCA) continued
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.23 Health Care Fraud Statute
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.24 Health Care Fraud Statute (continued)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.25 Criminal Health Care Fraud
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.26 Anti-Kickback Statute
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.27 Anti-Kickback Statute (continued)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.28 Stark Statute (Physician Self-Referral Law)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.29 Stark Statute (Physician Self-Referral Law)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.30 Civil Monetary Penalties (CMP) Law
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.31 Civil Monetary Penalties (CMP) Law (continued)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.33 Exclusion (continued)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.34 Health Insurance Portability and Accountability Act (HIPAA)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.35 Health Insurance Portability and Accountability Act (HIPAA)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.39 Knowledge Check Answer
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.41 Knowledge Check Answer
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.42 Lesson 2: Your Role in the Fight Against FWA
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.44 where Do I Fit In? (continued)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.45 Where Do I Fit In? (continued)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.46 Where Do I Fit in? (continued)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.47 Where Do I Fit In? (continued)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.48 What Are Your Responsibilities
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.49 How Do You Prevent FWA?
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.50 Stay Informed About Policies and Procedures
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.52 Reporting FWA Outside Your Organization
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.53 Where to Report FWA
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.55 Correction (continued)
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.56 Indicators of Potential FWA
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.57 Key Indicators: Potential Beneficiary Issues
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.58 Key Indicators: Potential Provider Issues
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.59 Key Indicators: Potential Pharmacy Issues
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.60 Key Indicators: Potential Wholesaler Issues
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.61 Key Indicators: Potential Manufacturer Issues
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.62 Key Indicators: Potential Sponsor Issues
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.66 Knowledge Check Answer
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.68 Knowledge Check Answer
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.70 Knowledge Check Answer
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.72 Knowledge Check Answer
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.74 Question 1 of 10
Once a corrective action plan is started, the corrective actions must be monitored
annually to ensure they are effective.
Correct Choice
True
False
1.75 Question 2 of 10
Ways to report potential Fraud, Waste, and Abuse (FWA) include:
Correct Choice
Telephone hotlines
Mail drops
In-person reporting to the compliance department/supervisor
Special Investigations Units (SIUs)
All of the above
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.76 Question 3 of 10
Any person who knowingly submits false claims to the Government is liable for
five times the Government’s damages caused by the violator plus a penalty.
Correct Choice
True
False
1.77 Question 4 of 10
These are examples of issues that should be reported to a Compliance
Department: suspected Fraud, Waste, and Abuse (FWA); potential health
privacy violation, and unethical behavior/employee misconduct.
Correct Choice
True
False
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.78 Question 5 of 10
Bribes or kickbacks of any kind for services that are paid under a Federal health
care program (which includes Medicare) constitute fraud by the person making
as well as the person receiving them.
Correct Choice
True
False
1.79 Question 6 of 10
Waste includes any misuse of resources such as the overuse of services, or other
practices that, directly or indirectly, result in unnecessary costs to the Medicare
Program.
Correct Choice
True
False
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.80 Question 7 of 10
Abuse involves payment for items or services when there is no legal entitlement
to that payment and the provider has not knowingly and/or intentionally
misrepresented facts to obtain payment.
Correct Choice
True
False
1.81 Question 8 of 10
Some of the laws governing Medicare Parts C and D Fraud, Waste, and Abuse
(FWA) include the Health Insurance Portability and Accountability Act (HIPAA);
the False Claims Act; the Anti-Kickback Statute; the List of Excluded Individuals
and Entities (LEIE); and the Health Care Fraud Statute.
Correct Choice
True
False
Published by Articulate® Storyline www.articulate.com 2017 CMS FWA Training
1.82 Question 9 of 10
You can help prevent Fraud, Waste, and Abuse (FWA) by doing all of the
following:
Look for suspicious activity;
Conduct yourself in an ethical manner;
Ensure accurate and timely data/billing;
Ensure you coordinate with other payers;
Keep up to date with FWA policies and procedures, standards of conduct, laws, regulations, and the Centers for Medicare & Medicaid Services (CMS) guidance; and
Verify all information provided to you.
Correct Choice
True
False
1.83 Question 10 of 10
What are some of the penalties for violating Fraud, Waste, and Abuse (FWA)
laws?
Correct Choice
Civil Monetary Penalties
Imprisonment
Exclusion from participation in all Federal health care programs
All of the above
2017 FWA Answer Key
1.74 Question 1 of 10
Once a corrective action plan is started, the corrective actions must be monitored
annually to ensure they are effective.
Correct Choice
True
X False
1.75 Question 2 of 10
Ways to report potential Fraud, Waste, and Abuse (FWA) include:
Correct Choice
Telephone hotlines
Mail drops
In-person reporting to the compliance department/supervisor
Special Investigations Units (SIUs)
X All of the above
1.76 Question 3 of 10
Any person who knowingly submits false claims to the Government is liable for
five times the Government’s damages caused by the violator plus a penalty.
Correct Choice
True
X False
1.77 Question 4 of 10
These are examples of issues that should be reported to a Compliance
Department: suspected Fraud, Waste, and Abuse (FWA); potential health
privacy violation, and unethical behavior/employee misconduct.
Correct Choice
X True
False
1.78 Question 5 of 10
Bribes or kickbacks of any kind for services that are paid under a Federal health
care program (which includes Medicare) constitute fraud by the person making
as well as the person receiving them.
Correct Choice
X True
False
1.79 Question 6 of 10
Waste includes any misuse of resources such as the overuse of services, or other
practices that, directly or indirectly, result in unnecessary costs to the Medicare
Program.
Correct Choice
X True
False
1.80 Question 7 of 10
Abuse involves payment for items or services when there is no legal entitlement
to that payment and the provider has not knowingly and/or intentionally
misrepresented facts to obtain payment.
Correct Choice
X True
False
1.81 Question 8 of 10
Some of the laws governing Medicare Parts C and D Fraud, Waste, and Abuse
(FWA) include the Health Insurance Portability and Accountability Act (HIPAA);
the False Claims Act; the Anti-Kickback Statute; the List of Excluded Individuals
and Entities (LEIE); and the Health Care Fraud Statute.
Correct Choice
True
X False
1.82 Question 9 of 10
You can help prevent Fraud, Waste, and Abuse (FWA) by doing all of the
following:
Look for suspicious activity;
Conduct yourself in an ethical manner;
Ensure accurate and timely data/billing;
Ensure you coordinate with other payers;
Keep up to date with FWA policies and procedures, standards of conduct, laws, regulations, and the Centers for Medicare & Medicaid Services (CMS) guidance; and
Verify all information provided to you.
Correct Choice
X True
False
1.83 Question 10 of 10
What are some of the penalties for violating Fraud, Waste, and Abuse (FWA)
laws?
Correct Choice
Civil Monetary Penalties
Imprisonment
Exclusion from participation in all Federal health care programs
X All of the above