Training and resource guide

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Training and resource guide

Postby brownlee47 » Mon Sep 01, 2014 10:35 am

on page 1.6 of the 2014 Namas training and resource guide, can you explain to me the difference in the monetary penalty $5,000-11,000 and the Medicare civil monetary penalty of S11,000. I am trying to figure out why the example used 36 claims x $11,000 instead of $10,000 since it was a medicare claim. Thank you in advance.
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Re: Training and resource guide

Postby admin » Tue Sep 02, 2014 2:29 pm

Thank you so much for your question, it will be sent on to our certified auditors. Once we receive a response the answer will be posted for you.
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Re: Training and resource guide

Postby admin » Mon Sep 08, 2014 12:56 pm

Answer provided by NAMAS team member Regan Tyler:

There are two different penalties referenced.

Violations of the False Claims Act (FCA) have a max fine up to $11,000

Civil Monetary Penalties (CMP) have a max fine up to $10,000

Often you can be charged with both. For test purposes you'll want to see which of the two fines they're referencing to determine the correct max fine amount.
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