5 Written Questions

1. prior to disclosing the individual's health information
2. variable-length file format is used to bill institutional, professional, dental, and drug claims
3. Regulated fraud associated with military contractors selling supplies and equipment to the Union Army
   
   Used by federal agencies to regulate the conduct of any contractor that submits claims for payment to the federal government for any program
   
   Amended in 1986 to increase civil monetary penalties (CMPs) to impose a maximum of $10,000 per false claim, plus three times the amount of damages that the government sustains, civil liability on those who submit false or fraudulant claims to the government for payment; and exclusion of violators from participation in Medicare and medicaid
4. intentional deception or misrepresentation that someone makes, knowing it is false, that could result in an unauthorized payment
5. is assigned to health care providers as a 10-character alphanumeric identifier, including a check digit in the last position

5 Matching Questions

1. National Drug Code (NDC)
2. listserv
3. security rule
4. case law/common law
5. National Standard Format (NSF)

1. a a subscriber-based question and answer forum available through e-mail
2. b flat file format used to bill physician and noninstitutional services, such as services reported by a general practioner on a CMS-1500 claim.
3. c adopts standards and safeguards to protect health information that is collected, maintained, used, or transmitted electronically
4. d maintained by the Food and Drug Administration (FDA), identifies prescription drugs and some over-the-counter products
5. e based on court decisions that establish a precedent (or standard)

5 Multiple Choice Questions

1. a leal newspaper published every business day by the National Archives and Records Administration (NARA). It is available in paper form, on microfiche, and online.
   1. Federal Register
   2. flat file
   3. interrogatory
   4. message digest
2. initiated by DHHS to require facilities to identify and reduce improper Medicare payments and specifically, the Medicare payment error rate
   1. National Provider Identifier (NPI)
   2. payment error rate
   3. Payment Error Prevention Program (PEEP)
   4. Current Dental Terminology (CDT)
3. a docyment containing a list of questions that must be answered in writing.
   1. encrypt
   2. interrogatory
   3. deposition
   4. authorization
4. a one-digit character, alphabetic or numeric, used to verify the validity of a unique identifier
   1. check digit
   2. precedent
   3. decrypt
   4. security
5. testimony under oath taken outside of court (e.g. at the provider's office)
   1. decrypt
   2. regulation
   3. authorization
   4. deposition

5 True/False Questions

1. Privacy Act of 1974 → creates national standards to protect individuals' medical records and other personal health information. This rules also gives patients greater access to their own medical records and more control over how their personal health information is used

   True        False

2. National Individual Identifier → is assigned to health care providers as a 10-character alphanumeric identifier, including a check digit in the last position

   True        False

3. privacy → the right of individuals to keep their information from being disclosed to others

   True        False

4. abuse → flat file is used to bill institutional services, such as services performed in hospitals

   True        False

5. qui tam → latin phrase which means "who as well for the king as for himself sues in this matter". It is a provision of the Federal False Claims Act, which allows a private citizen to file a lawsuit in the name of the U.S. government, charging fraud by government contractors and other entities that receive or use government funds, and to share in any money recovered.

   True        False