HCAFA Practice Questions - AHIP Health Care Anti-Fraud Associate (HCAFA) Designation Exam - HCAFA Practice Questions - AHIP Health Care Anti-Fraud Associate (HCAFA) Designation Exam

Question 1

Which element distinguishes health care fraud from waste or abuse under the NHCAA definition?

Intentional deception or misrepresentation knowing it could result in an unauthorized benefit Any billing error that causes financial loss to a payer Provision of services that are medically unnecessary but billed correctly Overutilization of services without any misrepresentation

Correct Answer:

Intentional deception or misrepresentation knowing it could result in an unauthorized benefit

Question 2

Which federal statute imposes treble damages plus per-claim civil penalties on persons who knowingly submit false claims to the government?

False Claims Act, 31 U.S.C. § 3729 Anti-Kickback Statute, 42 U.S.C. § 1320a-7b Stark Law, 42 U.S.C. § 1395nn HIPAA criminal provisions, 42 U.S.C. § 1320d-6

Correct Answer:

False Claims Act, 31 U.S.C. § 3729

Question 3

A whistleblower who files a False Claims Act lawsuit on behalf of the United States is known as what?

Qui tam relator under 31 U.S.C. § 3730(b) Special inspector under 31 U.S.C. § 3729(c) Compliance complainant under 42 U.S.C. § 1320c Civil monetary informant under 42 U.S.C. § 1320a-7a

Correct Answer:

Qui tam relator under 31 U.S.C. § 3730(b)

Question 4

Under the federal Anti-Kickback Statute (42 U.S.C. § 1320a-7b), what mental state is required for criminal liability?

Knowingly and willfully offering, paying, soliciting, or receiving remuneration to induce referrals Strict liability — no intent required Negligently approving payment for a referral Recklessly disregarding a Stark Law exception

Correct Answer:

Knowingly and willfully offering, paying, soliciting, or receiving remuneration to induce referrals

Question 5

Which statement best describes the Stark Law (42 U.S.C. § 1395nn)?

A strict-liability physician self-referral law prohibiting referrals for designated health services to entities with which the physician has a financial relationship, absent an exception A criminal statute requiring proof of intent to induce referrals A whistleblower retaliation statute applicable only to Medicare Advantage plans A Civil Monetary Penalty provision targeting EMTALA violations

Correct Answer:

A strict-liability physician self-referral law prohibiting referrals for designated health services to entities with which the physician has a financial relationship, absent an exception

Question 1

Exam overview

About this Exam

Prepare with the HCAFA Practice Questions - AHIP Health Care Anti-Fraud Associate (HCAFA) Designation Exam practice quiz. This question bank includes 100 questions covering fraud, health, care, provider, and insurance. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

More details

Additional Information

HCAFA Practice Questions - AHIP Health Care Anti-Fraud Associate (HCAFA) Designation Exam

This practice set contains 100 questions from the matching question bank and focuses on fraud, health, care, provider, and insurance. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

This is an independent study resource intended for practice and review; it is not an official examination or an endorsement by any organization named in the title.

Quiz information

Frequently Asked Questions

The complete question count is available after full access is unlocked.

No fixed duration is currently configured for this quiz.

Question explanations are included where they are available in the quiz content, helping you review the reasoning after answering.

Yes. You can retake the practice test again as you continue studying during your available access period.

After your access is confirmed, you can continue into the complete practice exam from this quiz flow.

Unless explicitly stated otherwise, this page provides independent practice material for study and exam preparation and is not the official examination itself.

Keep studying

Correct Answer:

Correct Answer:

Correct Answer:

Correct Answer:

Correct Answer:

About this Exam

Additional Information

HCAFA Practice Questions - AHIP Health Care Anti-Fraud Associate (HCAFA) Designation Exam

Frequently Asked Questions

Related Questions

2026 Wellcare ACT Mastery Practice Exam

ArcGIS Online Administration Associate Practice Test

ArcGIS Online Administration Associate Practice Test

Archer Child Health Cardio/Respiratory Practice Exam

Arizona Caregiver Certification Practice Exam

Arizona Direct Care Worker Practice Exam