Fraud and Abuse Laws

Question 1

False Claims Act may also result from

Answer 1

A kickback

Violation of the Stark law

Question 2

Which is a strict liability statute, the False Claims Act, the Anti-Kickback Statute, or the Stark Law

Answer 2

Stark Law

Question 3

The Stark Law is also commonly referred to as

Answer 3

Physician Self-Referral Law

Question 4

What is prohibited by the Physician Self-Referral Law?

Answer 4

prohibits physicians from referring patients to receive “designated health services” payable by Medicare or Medicaid from entities with which the physician or an immediate family member has a financial relationship, unless an exception applies

Question 5

Under the Stark Law, who is considered an immediate family member?

Answer 5

• Grandparents, parents
• Husband/wife
• Child
• brother or sister
now think “step”
• stepparent
• stepchild
• stepbrother, or stepsister
Now think “in-laws”
• father-in-law, mother-in-law
• son-in-law, daughter-in-law,
• brother-in-law, or sister-in-law;

Question 6

Under Stark Law who is considered a physician

Answer 6

• MD
• DO
• Dentist
• Podiatrist
• Chiropractor
• Optometrist

Question 7

OIG is legally required to exclude individuals from Federal health care programs who are convicted of the following criminal offenses

Answer 7

• Medicare or Medicaid fraud
• Patient abuse or neglect
• Felony convictions for other health-care related fraud, theft, or other financial misconduct;
• Felony convictions for unlawful manufacture, distribution, prescription, or dispensing of controlled substances.

Question 8

True or false: Under the AntiKickback Statute, it is illegal to provide free or discounted services to uninsured people

Answer 8

False

Question 9

True or False: The Anti-kickback prohibition applies to referrals from patients

Answer 9

True

Question 10

Which of the Fraud and Abuse laws contains the whistleblower provision?

Answer 10

False Claims Act (FCA)