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Healthcare Fraud & Abuse 2020 (refer to brochure ICN 905645 for assistance)

Across
The Physician Self-Referral Law is also known as the _______ Law. (Page 5)
Under the ________Statute, the government may exclude from participation in all Federal health care programs individuals and entities convicted of Medicare Fraud and a variety of other offenses. (Page 5)
The civil _____Claims Act is also known as the FCA and protects the government from being overcharged or sold substandard goods or services. (Page 4)
An example of an improper claim includes billing for services that are considered ___________ unnecessary. (Page 7)
Providers are responsible for their own _______ Medical Education to maintain State licensure, hospital privileges, and board certification. (Page 13)
Providers who file insurance claims with a government payer are _________they earned the payment requested and complied with all the billing rules. (Page 7)
Down
The Anti-_______Statute is also known as AKS and makes it a crime to offer, pay, solicit or receive any remuneration to reward referrals. (Page 4)
The Civil ________ Penalties Law authorizes fines for a variety of health care fraud violations. (Page 6)
__________& Management Services are also referred to as E&M or E/M services and the billing codes for these services are listed in the CPT book (Page 8)
Providers must maintain documentation for services provided to patients and this documentation must be _______and complete. (Page 8)