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AHIP FRAUD WASTE AND ABUSE EXAM
NEWEST 2025 ACTUAL EXAM COMPLETE 150
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+
Which of these actions is most likely to be permitted in dealing with a person with limited English proficiency? - ANSWER-a.Allowing a child to interpret in an emergency. Correct
Under ACA Section 1557, sex discrimination includes a person's
- ANSWER-c. sex, pregnancy, sex stereotypes, or gender
identity. Correct
Under ACA Section 1557, a health plan sold through a state exchange may, based on an individual's age, - ANSWER-d.charge higher premiums. Correct
ACA Section 1557 rules for disability concern - ANSWER-d.Policies and procedures, physical access, and communication.Correct 1 / 3
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Which area of potential discrimination is not generally covered by ACA Section 1557? - ANSWER-c. Employment (with the exception of the provision of health insurance). Correct
As a result of violations of ACA Section 1557 nondiscrimination rules, - ANSWER-c. a health plan may revoke an agent or broker's appointment with the health plan. Correct
For a health plan, what are the possible consequences of violations of ACA Section 1557? - ANSWER-b. Loss of federal business and compensatory damages. Correct
If a health plan violates ACA Section 1557 nondiscrimination protections, it may be - ANSWER-c. required to take corrective action and sometimes pay damages, and it may be sued by individuals. Correct
Once a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective. - ANSWER-False
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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. - ANSWER-False
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. - ANSWER-True
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. - ANSWER-True Correct
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. - ANSWER-True
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;
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