Special care facilities generally have the capability to meet all patients' needs in-house, leading to a lower likelihood of fraud.

• A. True
• B. False
• C. Sometimes true
• D. Not enough information

Answer: (B)

The idea being tested is that simply delivering most care in-house doesn’t eliminate fraud risk. Even if a facility can meet many needs internally, fraud opportunities still exist in how services are billed, documented, and managed. Not everything can always be handled on-site—external specialists, vendors, or third-party services may be involved, creating chances for upcoding, billing for services not rendered, duplicate charges, or improper referrals. Internal control weaknesses, ghost employees, theft of supplies, and kickbacks can also persist regardless of how much care is provided in-house. So, while in-house capability can improve coordination and continuity of care, it does not guarantee a lower likelihood of fraud.