Abuse Is Knowingly and Willfully Executing or Attempting to Execute

question 19

Multiple Choice

Abuse is knowingly and willfully executing or attempting to execute a scheme to defraud any healthcare benefit program. Fraud is an unintended action that results in an overpayment to the healthcare provider.

• A) Both statements are true.
• B) Both statements are false.
• C) The first statement is true and the second statement is false.
• D) The first statement is false and the second statement is true.

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Definitions:

Risk-Averse

A characteristic of individuals preferring outcomes with certain, lower returns compared to outcomes with uncertain, potentially higher returns.

Risk Aversion

The behavior of individuals who, when exposed to uncertainty, would prefer to choose an outcome with a more certain but possibly lower payoff over an outcome with a higher payoff but more uncertainty.

Equilibrium Premium

The price level at which supply and demand for a financial instrument, such as insurance, are balanced, minimizing the risk of loss for insurers.

Equilibrium Quantity

The volume of products or services on offer equals the volume sought by consumers at the equilibrium price in the market.