Compliance & RegulatoryQuestion 88 of 100
A 'qui tam' provision under the False Claims Act allows:
a.Providers to appeal any denial
b.Patients to change their diagnosis
c.Payers to set fee schedules
d.A private individual (a whistleblower) to file suit on behalf of the government and potentially share in any recovery
Explanation
The qui tam provision lets a private person, often an employee who discovers fraud, bring a lawsuit on the government's behalf and receive a portion of amounts recovered. This encourages insiders to report false claims. The law also protects such whistleblowers from retaliation.
Law Reference: False Claims ActPractice all 100 questions free — no signup required.
Related questions on this topic
- Under HIPAA, a patient generally has the right to:
- The HIPAA transactions and code sets standards were established to:
- The federal False Claims Act imposes liability primarily on those who:
- The federal Anti-Kickback Statute prohibits:
- The physician self-referral law (the Stark Law) generally prohibits a physician from:
- The Office of Inspector General (OIG) of the Department of Health and Human Services is primarily responsible for:
Last reviewed: · editorial process
PrepPass Editorial Team · Verified against NHA Certified Billing & Coding Specialist (CBCS) Exam · How we review