Question

question 4 of 10

select the correct answer.

a chiropractor, in an intentional attempt to falsely get medicare program money, billed medically unnecessary services and falsified the beneficiarys medicare claim diagnosis. depending on the facts and circumstances, she most likely committed _______

a. a violation of the anti-kickback statute
b. a violation of the physician self-referral law (stark law)
c. medicare fraud or abuse because she knowingly submitted false medicare program claims

Explanation:

Analyze the scenario

The scenario describes a chiropractor who intentionally attempts to falsely obtain Medicare Program money by billing for medically unnecessary services and falsifying diagnoses.

Define Medicare fraud and abuse

Medicare fraud is defined as knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any healthcare benefit program. This includes knowingly submitting false claims or making misrepresentations to obtain payment.

Evaluate the options

• Option A (Anti-Kickback Statute) involves receiving rewards for referrals, which is not described here.
• Option B (Stark Law) involves self-referrals for designated health services, which is not described here.
• Option C directly matches the definition of Medicare fraud or abuse, as she knowingly and intentionally submitted false claims to obtain Medicare funds.

Answer:

• A. A violation of the Anti-Kickback Statute
• B. A violation of the Physician Self-Referral Law (Stark Law)
• C. Medicare fraud or abuse because she knowingly submitted false Medicare Program claims (Correct answer)