Question 1

A pharmacist who submits Medicaid claims for reimbursement on brand name medications rather than on the less expensive generic drugs actually dispensed is considered __________.

Accepted Answer

A)   perjury
B)   malpractice
C)   wrongful kickback
D)   fraud D

Question 2

Detectives are assigned to cases when necessary to gather __________.

Accepted Answer

A)   evidence
B)   background related cases
C)   legal case issues
D)   policies, procedures A

Question 3

Intentional injection of a lethal dose of a medication by a nurse into a patient is __________.

Accepted Answer

A)   fraud
B)   manslaughter
C)   murder
D)   negligence C

Question 4

If a health care provider shows reckless disregard for the safety of his patients and intentional indifference to any injury that could follow his act(s), he could be charged with or sued for __________.

Accepted Answer

A)   assault
B)   criminal negligence
C)   tortious interference
D)   civil negligence

Question 5

__________ reckless disregard for the safety of others and the willful indifference to an injury that could follow is defined as a

Accepted Answer

A)   tort
B)   crime
C)   fraud
D)   criminal negligence

Question 6

Conferencing a case in an attempt to avoid a trial and reach an acceptable conclusion to the parties __________.

Accepted Answer

A)   indictment
B)   arraignment
C)   plea-bargaining
D)   deterrent to crime

Question 7

Upcoding medical supplies and equipment and billing for more expensive equipment than that delivered to patients are examples of __________.

Accepted Answer

A)   tort
B)   res ipsa loquitur
C)   fraud
D)   petty theft

Question 8

When members of a hospital council governing body solicit and receive money for special consideration in awarding a project to an architectural firm on a building project, they could be convicted of __________.

Accepted Answer

A)   negligence
B)   mandamus
C)   kickbacks
D)   fulfilling his fiduciary responsibility

Question 9

The numerous scams in home care fraud are caused by the __________ in supervising services provided in the home,

Accepted Answer

A)   ease
B)   difficulty
C)   reluctance
D)   lack of enthusiasm

Question 10

If a person presents or causes to be presented a false claim to the government, for the purpose of getting the false claim paid by the government, he or she can be charged with violating the __________.

Accepted Answer

A)   Anti-Kickback Statute
B)   Medicare and Medicaid Patient Protection Act of 1987
C)   Patient Protection and Affordable Care
D)   False Claims Act

Question 11

Beginning in 1989 and continuing into the 1990s, when the AMA Council on Ethical and Judicial Affairs began to pass a series if acts specifically aimed at Physicians' ethical practices, they were targeting __________.

Accepted Answer

A)   having labs in their offices
B)   not accepting Medicaid patients
C)   forming boutique practices
D)   self-referrals

Question 12

A __________ presents criminal cases to a grand jury

Accepted Answer

A)   court clerk
B)   defendant
C)   judge
D)   prosecutor

Question 13

Prosecution of a crime generally begins with __________.

Accepted Answer

A)   plea bargaining
B)   arrest
C)   preliminary conference
D)   bail

Question 14

The __________ Act prohibits physicians who have ownership interest or compensation arrangements with a clinical laboratory from referring Medicare patients to that laboratory.

Accepted Answer

A)   Health Insurance Portability and Accountability
B)   Ethics in Patient Referral
C)   Public Health Services
D)   Patient Protection and Affordable Care

Question 15

When a health care facility comingles its funds with those of its patients, it violates its __________ with those patients.

Accepted Answer

A)   debtor- creditor relationship
B)   consent relationship
C)   privilege relationship
D)   fiduciary responsibility

Question 16

Conditioning the award of a contract on an under-the-table percentage payback to a public official who has the ability to influence who will be awarded the contract is known as a __________.

Accepted Answer

A)   solicitation
B)   arbitration
C)   criminal negligence
D)   kickback

Question 17

The Office of Inspector General, established in the Department of Health and Human Services in 1976, investigates cases of __________.

Accepted Answer

A)   criminal mischief
B)   Medicare and Medicaid fraud
C)   petty theft
D)   patient abuse

Question 18

Submission of multiple bills for single office visits is a __________.

Accepted Answer

A)   fraud
B)   perjury
C)   criminal negligence
D)   tort

Question 19

The intentional removal of life-support equipment can be considered the crime of __________.

Accepted Answer

A)   petty theft
B)   murder
C)   battery
D)   assault

Question 20

Serious crime generally punishable by one or more years of imprisonment in a state or federal penitentiary is a __________.

Accepted Answer

A)   misdemeanor
B)   malicious mischief
C)   felony
D)   false imprisonment

Exam 4: Criminal Aspects of Health Care