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Med. Insurance Terms

Medical Insurance in a Flash Chapter 15

QuestionAnswer
What is the program developed by CMS to monitor and report the accuracy of Medicare claims? CERT
How many claims are selected for a CERT review? 120,000
What act ensures that all people have an equal chance to obtain credit when needed? Equal Credit Opportunity Act
This act applies to the disputes in billing errors. Fair Credit Billing Act
In what month does the OIG release it's work plan? October
Per the OIG, how many potential risk areas are there within a physician practice? 4
What does Regulation Z do? Handles Credit Issues
This act provides clear rules on lending arrangements. Truth in Lending Act
HIPAA contains how many titles? 2
The Privacy Rule is part of what act? HIPAA
This change in language that requires free care to certain patients is part of what act? Hill-Burton Act
What act monitors spending for Medicare, Medicaid, and Social Security? Deficit Reduction Act
The increase of reward for quitam suits was a 1986 revision of what act? Federal Civil False Claims Act
According to the LEIE, a conviction related to the abuse or neglect of a patient carries what exclusion time period? Minimum of 5 Years
The National Practitioner Data Bank was created out of what act? Health Care Quality Improvement Act of 1986
The Stark Laws fall under what act? Omnibus Budget Reconciliation Act
The words, "knowing and willingly", were added as the criteria of "intent" under what act? Anit-kicback Statute of 1974
The central healthcare fraud and abuse database is called what? Health Care Fraud and Abuse Data Collections Program
Medicare beneficiaries can collect a reward under this program. Beneficiary Incentive Program
This program authorizes audits, investigations, and inspection relating to the delivery of healthcare. Fraud and Abuse Control Program
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