Certified Application Counselor Practice Test

To whom should you report a suspected case of consumer falsification of information in coverage enrollment?

1. Local law enforcement

2. Company Compliance Department

3. Fraud Hotline of the HHS Office of the Inspector General

4. Marketing Department of the insurer

The correct answer is: Fraud Hotline of the HHS Office of the Inspector General

The correct course of action for reporting a suspected case of consumer falsification of information in coverage enrollment is to contact the Fraud Hotline of the HHS Office of the Inspector General. This office is specifically tasked with overseeing and investigating allegations of fraud within health care programs, including those pertaining to enrollment in coverage. Reporting to this entity ensures that the case is handled by professionals who are trained to address such serious matters in the context of healthcare integrity. The other options do not provide the same targeted response. Local law enforcement, while capable of dealing with various forms of fraud, may not have the specialized knowledge necessary for health coverage issues. The Company Compliance Department may not be equipped to handle external consumer fraud directly. Lastly, the Marketing Department of the insurer would not be appropriate, as their focus is typically on promoting products rather than investigating potential fraudulent activities. Thus, reaching out to the Fraud Hotline of the HHS Office of the Inspector General allows for the most effective and appropriate action in situations of suspected falsification during coverage enrollment.