Fraud Waste And Abuse Study Guide Graded A+

You are performing a regular inventory of the controlled substances in the pharmacy. You discover a minor inventory discrepancy. What should you do? {Ans: c. Follow your pharmacy's procedures. Correct}As a result of violations of ACA Section 1557 nondiscrimination rules, {Ans: c. a health plan may revoke an agent or broker's appointment with the health plan. Correct}Ways to report potential Fraud, Waste, and Abuse (FWA) include: {Ans: e. All of the above Correct}These are examples of issues that can be reported to a Compliance Department: suspected Fraud, Waste, and Abuse (FWA); potential health privacy violation, and unethical behavior/employee misconduct. {Ans: True}You work for a Sponsor. Last month, while reviewing a Centers for Medicare & Medicaid Services (CMS) monthly report, you identified multiple individuals not enrolled in the plan but for whom the Sponsor is paid. You spoke to your supervisor who said don't worry about it. This month, you identify the same enrollees on the report again. What should you do? {Ans: b. Although you know about the Sponsor's non-retaliation policy, you are still nervous about reporting—to be safe, you submit a report through your compliance department's anonymous tip line to avoid identification}Under Section 1557,