Which of the following is NOT considered fraud/misconduct under the False Claims Act?

Get ready for the AAPC Certified Professional Medical Auditor Test. Enhance your skills with multiple choice questions, each designed to provide thorough explanations. Excel in your exam preparation!

Submitting claims for services performed is not considered fraud or misconduct under the False Claims Act because it pertains to legitimate claims that accurately reflect services provided to patients. If the services are legitimately performed and well-documented, they do not violate any laws, unlike the other options, which involve deceptive practices.

Falsifying a medical chart notation, for example, constitutes fraud because it misrepresents the patient's condition or treatment provided, leading to inappropriate billing and misuse of healthcare resources. Similarly, upcoding or unbundling services involves billing for more expensive services than those actually performed or splitting services into multiple claims to increase reimbursement, both of which are clear forms of fraud. Submitting claims for expired drugs can also be deemed fraudulent, as it indicates that a provider is billing for items that should not be dispensed due to safety and regulatory issues.

Overall, the act of submitting claims for services provided accurately does not mislead anyone and adheres to compliance regulations, thereby distinguishing it from fraudulent actions defined in the False Claims Act.

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