Question

Which federal agency employs a four-part strategy to deter fraud and abuse?

a. Centers for Medicare and Medicaid Services
b. Payment Error Prevention Program
c. HIPAA
d. False Claims Act

Answer 1

The federal agency that employs a four-part strategy to deter fraud and abuse is the Centers for Medicare and Medicaid Services (CMS). Their strategy includes prevention, detection, enforcement, and recovery.

Step-by-step explanation:

The federal agency that employs a four-part strategy to deter fraud and abuse is the Centers for Medicare and Medicaid Services (CMS). This agency is responsible for administering the Medicare and Medicaid programs, which provide healthcare coverage for certain populations in the United States.

The four-part strategy employed by CMS includes:

1. Prevention: CMS works to prevent fraud and abuse through implementing policies, regulations, and controls. They also educate healthcare providers and beneficiaries about proper billing practices and identify potential fraud risks.
2. Detection: CMS uses data analysis, audits, and investigations to detect instances of fraud and abuse. They utilize various tools and technologies to identify suspicious billing patterns and behavior.
3. Enforcement: CMS works with law enforcement agencies, such as the Office of Inspector General (OIG), to investigate and prosecute cases of fraud and abuse. They have the authority to impose penalties, fines, and exclusions on individuals and entities found guilty of fraudulent activities.
4. Recovery: CMS seeks to recover funds lost to fraud and abuse. They have a Recovery Audit Contractor (RAC) program that identifies and recovers improper payments made by Medicare and Medicaid.