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Health Insurance Fraud and Abuse

This quiz will test your knowledge on Health Insurance Fraud and Abuse.

15 Questions Published
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Questions

Question 1 Multiple Choice (Single Answer)

What is the most common type of health insurance fraud?

  1. Billing for services not rendered
  2. Upcoding
  3. Unbundling
  4. Phantom billing
Question 2 Multiple Choice (Single Answer)

What is upcoding?

  1. Billing for a higher level of service than was actually provided
  2. Billing for a service that was not medically necessary
  3. Billing for a service that was not covered by the patient's insurance plan
  4. All of the above
Question 3 Multiple Choice (Single Answer)

What is unbundling?

  1. Billing for each individual component of a service that is normally billed as a single unit
  2. Billing for a service that was not medically necessary
  3. Billing for a service that was not covered by the patient's insurance plan
  4. All of the above
Question 4 Multiple Choice (Single Answer)

What is phantom billing?

  1. Billing for a service that was never actually performed
  2. Billing for a service that was not medically necessary
  3. Billing for a service that was not covered by the patient's insurance plan
  4. All of the above
Question 5 Multiple Choice (Single Answer)

What are the consequences of health insurance fraud?

  1. Fines
  2. Imprisonment
  3. Exclusion from participation in Medicare and Medicaid
  4. All of the above
Question 6 Multiple Choice (Single Answer)

What can you do to report health insurance fraud?

  1. Contact your state's Medicaid Fraud Control Unit
  2. Contact the National Health Care Anti-Fraud Association
  3. Contact the FBI
  4. All of the above
Question 7 Multiple Choice (Single Answer)

What is the False Claims Act?

  1. A law that prohibits knowingly submitting false or fraudulent claims to the government
  2. A law that prohibits knowingly submitting false or fraudulent claims to private health insurers
  3. A law that prohibits knowingly submitting false or fraudulent claims to both the government and private health insurers
  4. None of the above
Question 8 Multiple Choice (Single Answer)

What is the Stark Law?

  1. A law that prohibits physicians from referring patients to entities in which they have a financial interest
  2. A law that prohibits hospitals from entering into exclusive contracts with physicians
  3. A law that prohibits health insurers from discriminating against providers who do not participate in their networks
  4. None of the above
Question 9 Multiple Choice (Single Answer)

What is the Anti-Kickback Statute?

  1. A law that prohibits offering, paying, soliciting, or receiving any remuneration in exchange for referrals of patients or patronage
  2. A law that prohibits physicians from self-referring patients
  3. A law that prohibits hospitals from entering into exclusive contracts with physicians
  4. None of the above
Question 10 Multiple Choice (Single Answer)

What is the Health Insurance Portability and Accountability Act (HIPAA)?

  1. A law that protects the privacy of health information
  2. A law that prohibits discrimination against individuals with pre-existing conditions
  3. A law that requires health insurers to cover a minimum set of benefits
  4. None of the above
Question 11 Multiple Choice (Single Answer)

What is the Medicare Fraud and Abuse Statute?

  1. A law that prohibits knowingly submitting false or fraudulent claims to Medicare or Medicaid
  2. A law that prohibits physicians from self-referring patients
  3. A law that prohibits hospitals from entering into exclusive contracts with physicians
  4. None of the above
Question 12 Multiple Choice (Single Answer)

What is the Medicaid Fraud and Abuse Statute?

  1. A law that prohibits knowingly submitting false or fraudulent claims to Medicaid
  2. A law that prohibits physicians from self-referring patients
  3. A law that prohibits hospitals from entering into exclusive contracts with physicians
  4. None of the above
Question 13 Multiple Choice (Single Answer)

What is the Employee Retirement Income Security Act (ERISA)?

  1. A law that regulates employee benefit plans
  2. A law that prohibits discrimination against individuals with pre-existing conditions
  3. A law that requires health insurers to cover a minimum set of benefits
  4. None of the above
Question 14 Multiple Choice (Single Answer)

What is the Affordable Care Act (ACA)?

  1. A law that reformed the health insurance industry in the United States
  2. A law that prohibits discrimination against individuals with pre-existing conditions
  3. A law that requires health insurers to cover a minimum set of benefits
  4. All of the above
Question 15 Multiple Choice (Single Answer)

What is the role of the Centers for Medicare & Medicaid Services (CMS) in combating health insurance fraud and abuse?

  1. CMS is responsible for investigating and prosecuting health insurance fraud and abuse
  2. CMS is responsible for setting standards for health insurance plans
  3. CMS is responsible for approving new drugs and devices
  4. All of the above
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