#1
Which organization oversees Medicare Parts C and D?
Centers for Medicare & Medicaid Services (CMS)
ExplanationCMS oversees Medicare Parts C and D.
#2
What is the primary goal of Medicare Part C?
To offer private health insurance plans
ExplanationMedicare Part C aims to provide private health insurance plans.
#3
What is the role of the Medicare Advantage Prescription Drug (MA-PD) plan?
To offer both medical and prescription drug coverage
ExplanationThe role of the MA-PD plan is to offer both medical and prescription drug coverage.
#4
Which government agency investigates Medicare fraud cases?
Department of Justice (DOJ)
ExplanationThe DOJ investigates Medicare fraud cases.
#5
What is a common method used in Medicare Part D fraud schemes?
Billing for services never rendered
ExplanationBilling for services never rendered is a common method used in Medicare Part D fraud schemes.
#6
Which of the following is considered an example of Medicare Part D fraud?
A pharmacist billing for medication never provided
ExplanationBilling for medication never provided constitutes Medicare Part D fraud.
#7
What is the purpose of a Medicare Compliance Program?
To prevent waste
ExplanationThe purpose of a Medicare Compliance Program is to prevent waste.
#8
What is an example of Medicare Part C abuse?
A provider overbilling for services not rendered
ExplanationOverbilling for services not rendered is an example of Medicare Part C abuse.
#9
Which of the following is NOT a component of an effective Medicare compliance program?
Encouraging fraudulent activities
ExplanationEncouraging fraudulent activities is NOT a component of an effective Medicare compliance program.
#10
What is an example of Medicare Part C waste?
A beneficiary visiting multiple doctors for the same issue
ExplanationA beneficiary visiting multiple doctors for the same issue is an example of Medicare Part C waste.
#11
Which federal law introduced stricter penalties for Medicare fraud?
The Affordable Care Act
ExplanationThe Affordable Care Act introduced stricter penalties for Medicare fraud.
#12
What is the purpose of the Medicare Drug Integrity Contractor (MEDIC)?
To investigate cases of Medicare fraud, waste, and abuse related to prescription drugs
ExplanationMEDIC investigates cases of Medicare fraud, waste, and abuse related to prescription drugs.
#13
Which federal agency manages the Medicare Advantage program?
Centers for Medicare & Medicaid Services (CMS)
ExplanationCMS manages the Medicare Advantage program.
#14
Which government agency operates the Medicare Drug Integrity Contractor (MEDIC) program?
Department of Health and Human Services Office of Inspector General (HHS-OIG)
ExplanationHHS-OIG operates the MEDIC program.
#15
What is the role of the Center for Program Integrity (CPI) within CMS?
Implementing compliance programs
ExplanationThe role of CPI within CMS is implementing compliance programs.