Some of the laws…. Some of the laws governing Medicare Parts C and D Fraud, Waste, and Abuse (FWA) include the Health Insurance Portability and Accountability Act (HIPAA); the False Claim Act; the Anti-Kickback Statute; the List of Excluded Individuals and Entities (LEIE); and the Health Care Fraud Statute. False
True Any request of distribution of PHI should contain only the minimum amount of PHI required to complete the intended task. False When completing an application, you should ensure that you enter the provider ID of a specialist and not a Primary Care Physician (PCP). Must include most of the required elements necessary to complete … Read more
Agent Don plans to conduct a marketing/sales event at the local public library on October 28 at 2pm. He received permission to post an advertisement on the library bulletin board starting October 14. What is the latest date Don could submit a NEW Event Request Form to UnitedHealthcare in order to comply with UnitedHealthcare’s event … Read more
Mrs. Andrews was…… Mrs. Andrews was preparing a budget for next year because she takes quite a few prescription drugs, she will reach the coverage gap, and wants to be sure she has enough money set aside for those months. She received assistance calculating her projected expenses from her daughter who is a pharmacist, but … Read more
Ordinarily, you ask….. Ordinarily, you ask your clients for referrals to people they think would benefit from the products you offer. When selling MA or Part D products, how might you solicit referrals? You may solicit referrals from current MA and Part D enrollees and offer one thank you gift per member per year of … Read more
Keep up to… Keep up to date with FWA policies and procedures, standards of conduct, and Medicare & Medicaid Services (CMS) guidance Verify all information provided to you True
Mr. Barker had… Mr. Barker had surgery recently and expected that he would have certain services and items covered by the plan with minimal out-of-pocket costs because his MA-PD coverage has been very good. However, when he received the bill, he was surprised to see large charges in excess of his maximum out-of-pocket limit that … Read more
