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  Los Angeles Lawyer
The Magazine of the Los Angeles County Bar Association
 
 

October 2010     MCLE Test and Answer Sheet

Test No. 196: Fraud Busters

 
 

Instructions for Obtaining MCLE Credit

The Los Angeles County Bar Association certifies that this activity has been approved for Minimum Continuing Legal Education credit by the State Bar of California in the amount of 1 hour. To apply for credit, please follow the instructions.

1. Study the CLE article.

2. Answer the test questions by marking the appropriate boxes. Each question has only one answer.

3. Photocopies of this answer sheet may be submitted; however, this form should not be enlarged or reduced. Mail the answer sheet and the $20 testing fee ($25 for non-LACBA members) to:

Los Angeles Lawyer
MCLE Test
P.O. Box 55020
Los Angeles, CA 90055 

Make checks payable to Los Angeles Lawyer.

4. You can also fill in the test form and submit it directly to LACBA by clicking "Submit." To submit your test answers online you will need to pay by credit card. After submitting your answers you will be presented with a screen requesting payment information. This information will be submitted in a secure mode which will allow you to safely transmit your credit card number over the Internet. If you prefer not to pay by credit card, please print this answer sheet and submit your responses by regular mail.

5. Within six weeks, Los Angeles Lawyer will return your test with the correct answers, a rationale for the correct answers, and a certificate verifying the CLE credit you earned through this self-assessment activity.

6. For future reference, please retain the CLE test materials returned to you.

 
  Test Sheet
 
 

Mark your answers to the test by clicking next to your choice.  All questions must be answered.  Each question has only one answer. This test is worth 1 hour of credit.*  

1. Healthcare reform will be paid for by:
 A. New and increased taxes.
 B. Cuts in provider payments.
 C. Fraud enforcement.
 D. All of the above.

2. Estimates place the annual losses from healthcare fraud at $75 to $250 billion.
 True.
 False.

3. Most of the money recovered from fraud enforcement actions is from physicians and small providers.
 True.
 False.

4. The Stark Law prohibition on physician referrals applies to:
 All services paid for by Medicare.
 B. All services covered by private insurance.
 C. A and B.
 D. Only "designated health services" covered by Medicare.

5. A Stark Law violation requires the government to prove criminal intent.
 True.
 False.

6. Beginning January 1, 2011, physicians who provide MRIs in their office must notify Medicare patients of alternative suppliers.
  True.
 False.

7. Amendments to the Stark Law will severely restrict physicians who are not already investors in hospitals from becoming owners of hospitals to which the physicians refer Medicare patients.
  True.
 False.

8. The Centers for Medicare and Medicaid Services (CMS) has always had the authority to reduce Stark Law penalties for providers who voluntarily disclose possible violations.
  True.
 False.

9. Violations of the federal Medicare-Medicaid antikickback statute can be punished by:
 A. Imprisonment.
 B. Fines.
 C. Exclusion from federal healthcare programs.
 D. All of the above.

10. Claims for goods, items, and services that result in a violation of the federal antikickback statute can also constitute violations under the False Claims Act.
 True.
 False.

11. Under the Patient Protection and Affordable Care Act (PPACA), within how many days of being identified must Medicare overpayments be reported and refunded?
 A. 30 days.
 B. 60 days.
 C. 90 days.
 D. None of the above.

12. Under prior law, courts were required to dismiss a qui tam lawsuit that was based on publicly disclosed information unless the relator was the original source of the information.
 True.
 False.

13. The PPACA requires that an original source must have firsthand and independent knowledge of the information upon which the claim is based.
 True.
 False.

14. The federal government wants to shift its healthcare enforcement emphasis from "pay and chase" to fraud prevention.
 True.
 False.

15. The CMS considers durable medical equipment (DME) and home health services to be low-risk areas for fraud and abuse.
 True.
 False.

16. Under the PPACA, a physician seeking Medicare payments must have a face-to-face or "telehealth" encounter with his or her patient before ordering DME or certifying the patient's need for home health services.
 True.
 False.

17. The PPACA expands the Recovery Audit Contractor (RAC) audit program to include:
 A. Medicare Part C.
 B. Medicare Part D.
 C. Medicaid.
 D. All of the above.

18. Manufacturers of drugs and devices covered under Medicare and Medicaid will not be required to report transfers of value to physicians and teaching hospitals until March 31, 2013.
 True.
 False.

19. The U.S. Department of Health and Human Services (HHS) can require a compliance program only for providers who have entered into a corporate integrity agreement with the Office of Inspector General.
 True.
 False.

20. The PPACA gives HHS authority to suspend Medicare payments to providers only after an investigation of possible fraud has been completed.
 True.
 False.

Address and Billing

After submitting your answers you will be asked to enter your name, address, and payment information on the next screen. Once you have submitted the current form, you will be switched to a secure mode which will allow you to safely transmit your credit card number over the Internet.

If you do not wish to complete this transaction over the Internet you should print this page and send it to the address listed in Step 3 of the instructions at the top of this page.


 
Before clicking the Submit button, please verify that all questions have been answered. An error message will appear if not all questions are answered.

* The Los Angeles County Bar Association has been approved as a continuing legal education provider of Minimum Continuing Legal Education credit by the State Bar of California. This self-assessment activity will qualify for Minimum Continuing Legal Education credit by the State Bar of California in the amount of one hour.

 


 
   
 

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