CORRECTING NON-COMPLIANCE. PROTECTS ENROLLEES, AVOID RECURRENCE OF THE SAME NON-COMPLIANCE, AND PROMOTES EFFCIENCY. STANDARDS OF CONDUCT ARE THE SAME FOR EVERY MEDICARE PARTS C AND PART D SPONSOR. FALSE.
Does Correcting Non Compliance Ensure Bonuses For Employees?
Correct Choice X Protects enrollees, avoids recurrence of the same non-compliance, and promotes efficiency Ensures bonuses for all employees Both A.
What Is The Policy Of Non Retaliation?
NON-RETALIATION POLICY. This policy is intended to reiterate the University prohibition on retaliation against those who report or seek guidance on ethical or compliance issues. Reports must be made in good faith. “Good faith” does not mean that an individual has to be right.
What Are Examples Of Issues That Can Be Reported To A Compliance Department?
Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper Management only. These are examples of issues that can be reported to a Compliance Department: suspected Fraud, Waste and Abuse (FWA); potential health privacy violation, and unethical behavior/employee misconduct.
Does An Effective Compliance Program Includes Four Core Requirements?
CMS requires an effective compliance program to include seven core requirements:
What Are The Consequences Of Non Compliance?
The consequences of non-compliance are not limited to statutory or legal penalties- the indirect costs to a company are often more significant. These include the inconvenience and cost of righting a mistake, damage to the company’s reputation or credit rating, and even possible loss of contracts.
What Are The Ways To Report A Compliance Issue?
To Report an Issue of Compliance, Privacy, or Fraud Call the anonymous HPP Hotline: 1-866-477-4848. Email: [email protected] Complete and submit anonymously online: EthicsPoint online reporting tool.
Are Standards Of Conduct The Same For Medicare Parts C And D Sponsor?
AT A MINIMUM, AN EFFECTIVE COMPLIANCE PROGRAM INCLUDES FOUR CORE REQUIRMENTS. MEDICARE PARTS C AND D PLAN SPONSORS ARE NOT REQIURED TO HAVE A COMPLIANCE PROGRAM.
What Is An Effective Compliance Program?
Establishing an effective Compliance and Ethics Program (“Program”) has become a necessity to protect any highly regulated organization. At its core, an effective Program protects an organization by detecting and preventing improper conduct and promoting adherence to the organization’s legal and ethical obligations.
What Are Some Of The Laws Governing Medicare Parts C And D?
Some of the laws governing Medicare Parts C and D Fraud, Waste, and Abuse (FWA) include the Health Insurance Portability and Accountability Act (HIPAA); the False Claims Act; the Anti-Kickback Statute; the List of Excluded Individuals and Entities (LEIE); and the Health Care Fraud Statute.
What Requires Intent To Obtain Payment And The Knowledge That The Actions Are Wrong?
Fraud requires the person have intent to obtain payment and the knowledge that their actions are wrong. Waste and abuse may involve obtaining an improper payment but not the same intent and knowledge.
Are Practices That Are Inconsistent With Sound Fiscal Business Or Medical Practices Resulting In Unnecessary Costs And Improper Payment?
provider practices that are inconsistent with sound fiscal, business, or medical practices, and that result in an unnecessary cost to the Medical Assistance Program, or that result in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for health care.”
What Is Considered Retaliation?
Retaliation occurs when an employer punishes an employee for engaging in legally protected activity. Retaliation can include any negative job action, such as demotion, discipline, firing, salary reduction, or job or shift reassignment. But retaliation can also be more subtle.
Who Is Responsible For Compliance In An Organization?
Corporate compliance creates and executes the organization’s corporate compliance program relative to its role. Management and all members of the organization are responsible for ensuring that compliance with laws, rules and regulations occurs.
What Is A Retaliation Policy?
Retaliation is in general defined as any kind of negative action against a current or former employee that takes the form of punishment, and creates a hostile, threatening or uncomfortable environment as a result of their reported complaint.
What Is A Compliance Concern?
Reporting Compliance Concerns. Sample compliance concerns might include: A situation that feels wrong and makes you uncomfortable. Concern that a particular transaction may be inappropriate given what you know about federal or other regulations or University policy.
How Do You Prove Retaliation In The Workplace?
If you file a lawsuit for retaliation, you’ll have to prove three things: You engaged in a protected activity. Your employer took action against you. There is a causal link between your activity and your employer’s action (in other words, your employer took action against you because of your activity).
What Are Some Penalties For Violating Fwa Laws?
Criminal Health Care Fraud Persons who knowingly make a false claim may be subject to: • Criminal fines up to $250,000 • Imprisonment for up to 20 years If the violations resulted in death, the individual may be imprisoned for any term of years or for life. For more information, refer to 18 USC Section 1347.
What Is General Compliance?
In general, compliance means conforming to a rule, such as a specification, policy, standard or law. Regulatory compliance describes the goal that organizations aspire to achieve in their efforts to ensure that they are aware of and take steps to comply with relevant laws, policies, and regulations.