Documentation - Test #2

The required topics of the HIPAA Privacy Notice

1) How the covered entity may use and disclose protected health information about an individual 2) The individual's rights with respect to the information and how the individual may exercise these rights, including how the individual may complain to the covered entity. 3)The covered entity's legal duties with respect to the information, including a statement that the covered entity is required by law to maintain the privacy of protected health information. 4) Whom individuals can contact for further information about the covered entity's privacy policies. In addition, the health service provider must include the date the policy took effect and the expiration date; the notice must be posted at the side of the health service and posted online at the entity's website. It must also be made available to anyone who would like to see it. Usually, clients or their guardians are asked to sign and date a document that says they have been provided with the privacy notice.

What must be removed for the document to be de-identified?

1) Name 2) All address information (street as well as e-mail, URL, and IP addresses) 3) Day and month of dates (year is acceptable) 4) Age, although age group is acceptable 5) Telephone and fax numbers 6) SSN 7) Medical record and health plan numbers 8) Vehicle or device identifiers 9) Biometric identifiers 10) Facial photographs 11) Any other unique information such as identification numbers, characteristics, or codes.

What are the ethical responsibilities regarding confidentiality for an occupational therapist?

1) Responsible for protecting the confidentiality of all client information regardless of the format of the communication

Ways to minimize the potential for breaches of confidentiality with the electronic health record?

1)Carefully limit the number of people who have access to individual client information through the use of passwords and other user verification methods. Only those caregivers who have a need to know should be assigned user names and passwords on the electronic health record system. Position computer screens so that no unathroized people, such as clients or visitors to the clinic can see it. Never walk away from a computer screen displaying confidential information without closing out the program.

The American Recovery and Reinvestment Act of 2009 (ARRA) further clarified what constitutes a breach of confidentiality. What is it?

A breach occurs when anyone who is not authorized to view, use, or disclose any protected health information

Plagiarism

A form of cheating and theft that has become very pervasive across the country. Defined as "to steal and pass off (the ideas or words of another) as one's own It includes using someone else's ideas, even if the wording is changed, without giving credit to the originator of the idea or words. Has a cultural element to it, some cultures believe that no one can "own" words, but in many Western cultures, and American culture in particular, words and ideas are considered to be the intellectual property of the writer or publisher, and cannot be used without giving credit to the author.

The American Recovery and Reinvestment Act of 2009 (ARRA)

Added new provisions related to the Health Insurance Portability and Accountability Act (HIPPA) concerning protection of client privacy The rules describe the kinds of information protected, when written consent is needed, and who may give consent.

Fundamentals of Documentation - Clinical Reasoning and Expertise

All documentation should demonstrate that the clinical reasoning and expertise of an occupational therapy practitioner is necessary for the safe and effective delivery of care.

Fundamentals of Documentation - Confidentiality

All federal, state, and agency/facility rules and regulations for confidentiality must be obeyed, including the AOTA Code of Ethics and Ethics Standards

Fundamentals of Documentation - Record Storage

All federal, state, and agency/facility rules and regulations for storage of records must be obeyed

Fundamentals of Documentation - Terminology

All terminology used must be recognized by the facility as acceptable. Official documents of the profession may be used to define terms, or the facility may specify terminology to be used by all professionals at the facility. This includes the term you use to identify the recipient of your services, for example, patient, client, resident, student

IDEA

Also contains language about privacy of info. IDEA has separate sections that address early intervention services (birth - 2) and school-age (3-21) services. Both sections specifically define identifying information such as the name of the child, parents or other family member; the address of the child; any identifier such as a SSN; or a list of characteristics or other info that would result in reasonable certainty of the identify of the child.

Individually identifiable health info is protected under HIPPA. What are examples of this type of info?

Any means by which a person could be identified - name, SSN, address, phone number. Examples of prohibited activities include using a client's SSN as a client identifier (case number) on written or electronic documentation and listing the full name of a client on a schedule hanging on a wall where anyone could see it.

Fundamentals of Documentation - Co-signature

As required by state, payer, or employer regulations, occupational therapists co-sign (also called countersigning) the signatures of occupational therapy assistants and students. This countersignature signifies that the occupational therapist has read the document and is in agreement with the conclusion drawn by the writer. The person countersigning the notes is obligated to make any necessary corrections or addendum to the notes before co-signing. This also provides documentation of supervision, which may be required by law.

Occupational therapist's ethical responsibility - Principle 3

Autonomy and Confidentiality. Occupational therapy personnel shall respect the right of the individual to self-determination. Ensure that confidentiality and the right to privacy are respected and maintained regarding all information obtained about recipients of service, students, research participants, colleagues, or employees. The only exceptions are when a practitioner or staff member believes that an individual is in serious foreseeable or imminent harm. Laws and regulations may require disclosure to appropriate authorities without consent. Maintain the confidentiality of all verbal, written, electronic, augmentative, and nonverbal communications, including compliance with HIPAA regulations

Penalties for Medicare fraud

Can cost the practitioner money, jail time, and his or her license to practice OT. There are both civil and criminal penalties for fraud and abuse. Civil penalities can include fines ranging from $10k to $50k per false claim as well as damages of three times the amount falsely billed can be assessed. Criminal penalties can also include imprisonment in a federal prison. A person participating in fraud can be excluded from ever participating in any federal reimbursement program such as Medicare, Medicaid, VA, Public Health Service Programs, and other goverment-funded programs.

Students who cheat in school are more likely to what?

Cheat in life - on their taxes, lie to customers, or engage insurance fraud by inflating claims

What are the two kinds of penalties for breaching confidentiality, according to the U.S. Dept of Health and Human Services?

Civil penalities: Health plans, providers, and clearinghouses that violate these standards will be subject to civil liability. Civil money penalties are $100 to $50,000 or more per violation, up to $1,500,00 per person, per year for each requirement or prohibition violated. Federal criminal penalties: A person who knowingly obtains or discloses individually identifiable health info in violation of the Privacy Rule may face a criminal penalty of up to $50,000 and up to one-year imprisonment. The criminal penalties increase to $100,000 and up to five years imprisonment if the wrongful conduct involves false pretenses, and to $250,000 and up to 10 years imprisonment if the wrongful conduct involves the intent to sell, transfer, or use identifiable health info for commercial advantage, personal gain, or malicious harm.

Summary of Chapter 8

Confidentiality is a major concern of all healthcare providers. As healthcare providers, we are obligated to protect the confidentiality of our clients. This applies to all settings, to all types of documents, and to spoken words as well. A federal law, HIPAA, limits the kind of information that can be shared without written permission and protects clients from public disclosure of any information. FERPA protects the educational records of students. Our clients deserve to have their privacy protected to the furthest extent possible without interfering with intervention.

What does clinical documentation typically consist of?

Documentation of the client's referral for services, a summary of the eval results (including the occupational profile and analysis of occupational performance), intervention plans, documentation of progress, attendance records, discharge summaries, and follow-up documentation. In essence, for each step of the OT process there is documentation to go with it.

Standard of proof in Medicare fraud cases

Does not require a specific intent to defraud the government. If one acts with "deliberate ignorance" or "reckless disregard," - if one does not know or understand the standards, but should know them, then that could be construed as fraud. Obviously, the OT practitioner is best advised to be truthful and accurate in all documentation in order to avoid claims of fraud.

Fundamentals of Documentation - Date and Time

Each document should be dated with the day, month, and year. Documentation of occupational therapy sessions (evaluation or intervention) often includes the time of day and sometimes the length of the session. Dates and times are used to show the chronological order of event.s

Principle 6D and 6E of the Code of Ethics say what?

Ensure that documentation for reimbursement purposes is done in accordance with applicable laws, guidelines, and regulations. Accept responsibility for any action that reduces the public's trust in OT Engaging in fraud violates the law and is damaging to the reputation of the profession

In order to make sure documents remain confidential, what procedures should you follow when faxing them? Email?

Fax - Include cover sheet marked "confidential," and make sure the person to whom you are sending the fax is there to receive it. Email - Only send confidential information by e-mail if it is an encrypted program. In other words, no one except those who have written consent of the client or the client's guardian should have access to a client's medical record in any form.

Fundamentals of Documentation - Corrections

Follow facility rules for correcting errors. Only correct your own errors. The most common method of correcting handwritten notes is to draw a line through the error and initial i. Some suggest writing the word error above the cross-out; but others suggest not doing that. Never do anything to obliterate erroneous documentation such as use white-out, scribble over an entry, or put tape over it. If the error occurs on an electronic health record, correct it using an addendum, and signed with an electronic signature.

Fundamentals of Documentation - Record Disposal

Follow federal and state laws as well as agency/facility policies and procedures for proper disposal of records

Fundamentals of Documentation - Technology

Follow professional standards and agency/facility rules and regulations for confidentiality must be obeyed, including the AOTA Code of Ethics and Ethics Standards

HIPAA Privacy Notice

Form clients must sign stating they have been informed of their rights, specifically how the health information will be used, what will be disclosed, and how the client can get access to this information. This form must be written in plain language so that it is readable by most adults, yet meets all the legal requirements of the law.

Summary - Chapter 9, Fraud

Fraud is a form of lying that is absolutely illegal. Fraud happens when an OT documents in such a way to create a false perception by the reader about what has actually transpired. Examples of fraud include documenting that you spend more time with a client than you really did, describing progress that is faster or flower than reality, or billing for services not rendered. There can be severe criminal and civil penalties for fraud. AOTA, in the Code of Ethics, explicitly prohibits OTs from making false statements. The best advice is to document accurately and be truthful in everything you do.

Def of fraud

Fraud is the deliberate concealment of the facts from another person for unlawful or unfair gain. Ex. - falsifying a diagnosis to justify additional tests or procedures and billing for services not provided but documenting as if you did

While many states have laws governing the protection of medical records, what type of information can be protected to an even greater degree?

HIV infection or drug/alcohol addiction. For example, releasing HIV status of a patient without permission to release that specific information can result in both civil and criminal penalties. A client could make claims of "intentional infliction of emotional distress"

Medicare fraud

Happens when a provider "knowingly or willingly lies to get paid"

Medicare abuse

Happens when a provider gets paid for services provided that were not medically necessary or when Medicare pays for services it should not have.

The Family Education Rights and Privacy Act (FERPA) of 1974

Identifies the confidentiality requirements of a student's educational record. The most recent revision of the regulations occurred in 2008 with the final regulations published on December 9th, 2008, in the Federal Register. If a student is receiving special education and related services (including OT), FERPA covers all documents that contain the student's name, address, phone number, parents' names, and any other identifying information.

Other examples of fraud

Intentionally using a billing code that you know will be reimbursed, rather than using a more accurate billing code that may not get reimbursed.

What occurs when third-party payers get involved in the care process, as tends to be the case with most therapy?

It adds an additional later of requirements that occupational therapy practitioners need to address in their documentation. Clinical settings for OT services may include medical or psychiatric hospitals, clinics, or long-term care settings as well as clients' homes, sheltered workshops, group homes, or other facilities.

Does the AOTA require the supervising OT co-sign documentation written by the OTA?

It does not require that an OT cosign documentation written by an OTA unless is it required by state law, their-party payer, or employer.

Occupational therapist's ethical responsibility - Principle 1

Item M: requires OT's to report any breaches of ethics, law, or policy to the appropriate authorities. If in the course of our fieldwork or practice we have firsthand knowledge of a breach, we have a duty to report it. The NBCOT also requires that occupational therapy practitioners obey laws, including those related to confidentiality.

Other common considerations for documentation

Legibility. All handwritten documentation needs to be legible. For some people, this means printing or typing rather than writing in script. The integrity of the health record is critical. Never write in a clinical record on behalf of another provider, allow another provider to alter your documentation, or document for you. And only document what you actually witnessed occurring

Common considerations for documentation

Most handwritten documentation is done in blue or black ink because often the documents must be copied and other colors of ink do not photocopy well. Never document in a permanent medical record using a pencil. Some facilities do not allow practitioners to document using erasable pens. Others require the ink to be waterproof.

Occupational therapist's ethical responsibility - Principle 2

Nonmaleficence. Occupational therapy personnel shall intentionally refrain from actions that cause harm. Avoid compromising client rights or well-being based on arbitrary administrative directives by exercising professional judgment and critical analysis This means that we avoid compromising the client's right to privacy by disclosing protected health information to anyone who does not have permission to access that information.

Fundamentals of Documentation - Placement of signature

Notes should be signed directly at the end of the notes; there should be no space between what is written and the signature. This can help prevent someone else from tampering with your documentation. Some facilities have the staff draw a line where there is blank space between the end of a notes and the signature. ON an electronic documentation system, once the notes is signed, it cannot be altered. If corrections need to be made, they are done as an addendum to the original note.

Why is plagiarism a such a big deal in OT programs?

OT is a profession where competence and integrity are essential, therefore catching cheaters at an early stage in their careers can help keep the profession respectable. Plagiarizing in school without consequences could start a slippery slope toward falsifying documentation and engaging in fraud as a clinician.

Health Insurance Portability and Accountability (HIPAA)

OT's are required by law to comply with HIPAA. This law covers many topics, including protections for American workers regarding health insurance, standardization of electronic patient records; and a section on protection of privacy rights of individuals. It protects all health info "that relates to the past, present, or future physical or mental health condition"

Example of OT plagiarism and not plagiarizing

OT's plagiarize when they copy someone else's intervention plan wording - this may also be a breach of confidentiality Electronic documentation, which uses standardized phrases that a clinician clicks on to add to the documentation, would NOT be considered plagiarism

Other things OT's should NOT do in order to protect patient confidentiality

OT's should not discuss with clients or about clients in public areas of the facility (especially in the hallways, the cafeteria, and in elevators) where they can be overheard.

The AOTA's Occupational Therapy Code of Ethics and Ethical Standards says what about plagiarism directly?

Occupational therapy personnel shall give credit and recognition when using the work of others in written, oral, or electronic media. (Principle 6I) and Principle 6J requires occupational therapy personnel to "not plagiarize the work of others" Further, Principle 6B additionally reminds occupational therapy personnel to "refrain from using or participating in the use of any form of communication that contains false, fraudulent, deceptive, misleading or unfair statements or claims." These apply to coursework as well as publications, public presentations, and in-service education, in academic, social, and clinical settings.

Fundamentals of Documentation - Compliance

Occupational therapy practitioners comply with all laws, regulations, as well as payers and employer requirements

Copyright infringement

Occurs when someone copies something that someone else has written without getting permission from the creator or publisher. For example copying journal articles for everyone in the department or on a committee is copyright infringement unless you have written permission from the publisher.

What is considered billable time?

Only the time the client spends with the therapist is considered billable time. The time an aide spends taking a client to and from the clinic, time spent resting in the therapy room, and time the therapist spends documenting care or on the phone talking to other caregivers are not billable time. It also means that documenting slower progress than is accurate in order to justify keeping a client on one's caseload longer, or faster progress than is accurate to look more effective, is consider fraudulaent.

The electronic health record - pros and cons

Pro - made accessing private health information more efficient Con - new possibilities for violating the confidentiality of clients

Exceptions to the rules for HIPAA

Providers may use and disclose protected health information without written authorization from the individual for treatment; victims of abuse, neglect, or domestic violence; judicial and law enforcement purposes; and health oversight. Protected health information may also be released if it has been de-identified.

What is paraphrasing?

Rearranging the order of a sentence, summarizing a passage or changing a few or the words. The source needs to be credited each time it is paraphrased

Summary of Chapter 8 con't

Record are retained for at least the length of each state's statute of limitations, and often longer. These records are also protected and stored where they will be safe and secure. Access to stored records is limited to only those who absolutely need access to them. Once the statute of limitations has expired, the records may stay in a secure and locked site, or be thoroughly destroyed by burned or shredding. Never toss old records into the garbage.

Confidentiality

Refers to keeping information to oneself, not releasing information about a client without the written permission of that client.

What does the AOTA Code of Ethics and Ethical Standards specifically state in Principle 6B?

Refrain from using or participating in the use of any form of communication that contains false, fraudulent, deceptive, misleading, or unfair statements or claims. This applies to OT documentation, adverting, and promotional materials, speeches and in-services, or any other form of communication that an OT might engage in regardless of the setting.

Plagiarism in OT school

Sharing intervention plans - if you use them to write your own intervention plan, you are stealing another student's work. You should give credit to the friend, although most teachers want students to do their own work Using another students work prevents you from learning and gaining skills needed for the real world. If this was a pattern of behavior, more serious consequences could occur - including expulsion from the program and school. Disciplinary action could also be taken against the student who shared their work b/c it contributes to the problem

Healthcare providers - HIPAA

Stipulates that both the medical record and billing record of each client be protected. Under the act, disclosure is defined as "the release, transfer, provision of access to, or divulging in any other manger of information outside the entity holding the information" Health information that is necessary for what the act calls "health care operations" does not require written permission of the client before being hsared.

Examples of Medicare fraud and abuse

Submitting a claim for payment for a service that was never delivered Submitting false documentation for payment Billing for therapy services that were not delivered face-to-face Billing for therapy services not provided by a licensed provider (e.g. student) Upcoding: Billing using a therapy code that is reimbursed at a higher rate than the rate for the code for therapy service that was actually delivered Participating in a kickback scheme that involves a physician receiving payment for patient referrals.

Read over story of fraudulent activity on p. 85

Summary - cannot add on unit's of billable time for documentation, phone calls, clean-up Cannot destroy progress notes when the next intervention plan is released (violation of the law)a

The Guidelines for Documentation of Occupational Therapy

The AOTA's standards for documentation Lists 15 fundamentals of all occupational therapy documentation.

What professional writing standards does the AOTA use?

The American Psychological Associate (APA)

If the individually identifiable health information is included in an educational record, what public law is it governed by?

The Family Education Rights and Privacy Act (P.L. 93-380)

In July 2006, what group took the unusual step of sending a letter to members of the AOTA, the APTA, and the ASLHA emphasizing the importance of using hte highest standards of ethics and clinical reasoning documenting the justification for Medicare B therapy cap exceptions?

The Tri-Alliance, a group made up of representatives of the AOTA, the American Physical Therapy Association, and the American Speech-Language-Hearing Association.

Fundamentals of Documentation - Client identification

The client's full name should be mentioned on every page, along with the client's case number, if there is one. The case number may be a medical records number, room/bed number, or other number, whichever is used at a particular facility or program.

What was the concern that prompted the letter sent out by the Tri-Alliance in 2006?

The concern was that the Centers for Medicare and Medicaid Services stated "they do not believe a large number of services should exceed the cap.", and if postpayment reviews show that exceptions exceeded expectations, that could result in a stricter cap being placed on therapy services. It is critical that documentation is appropriate to justify additional treatment.

If there is a breach of confidentiality, what has to happen?

The covered entity must notify the person; the U.S.Secretary of Health and Human Services; and, if the breach involves more than 500 people, the media.

FERPA con't

The file may be called a "cumulative file, permanent record, or official educational record". These files contain documents such as the IEP, the Individual Family Service Plan (IFSP), and notice and consent forms required by IDEA, as well as grades, samples of student work, and district-or statewide test results.

The Occupational Therapy Practice Act

The law that describes how occupational therapy practitioners become licensed or registered to practice in that state Describes the requirements for supervision of OTAs including the frequency, type and how that supervision is documented. Some states not only require a co-signature by the OT but a log supervisory visits.

Who should document - OT or OTA?

The occupational therapist has primary responsibility for assuring that documentation is completed in compliance with standards. The OT practitioner who provided the services to the client is the person who should document that session's services. If the documentation is written by an OTA, the documentation is often cosigned by the supervising OT as a way to show that supervision has occurred and that OT has read the documentation

Fundamentals of Documentation - Type

The type of documentation should be clearly stated, as should the name of the facility/agency and department. For example, the type of document may appear at the top of the page, and the name of the department may be under the signature line.

Fundamentals of Documentation - Signature

The writer should sign the document using at least his or her first initial and full last name followed by the appropriate professional designation (e.g. OTR, COTA). Using initials only is usually not sufficient. In some cases, such as on an attendance log, the OT might place his or her initials in the space for each day. At the bottom of the page there should be multiple signature lines so that for each set of initials appearing on the page, there is a full name and credentials written out to clearly identify the person who worked with the client. In an electronic health record, the signature will be recorded electronically rather than by hand.

Other rights individuals are granted under HIPAA

They can request an accounting of the people to whom personal health info was disclosed and the dates of the disclosures. They also have the right to read and copy their health information. They can also request that disclosure of their health information be restricted in some way.

What is something that individuals do not have an automatic right to under HIPAA?

They do not have an automatic right to access their entire medical record. Psychotherapy notes; information on a criminal, civil, or administrative action or proceeding; and information that "a qualified provider has determined would endanger the life of the individual if he had access to it" may be withheld from the individual

How does an OT practitioner avoid allegations of fraud?

They must be knowledgeable of the regulations, must follow those regulations, and must document with sufficient accuracy and honesty. There have been numerous cases where occupational therapy practitioners and others have been accused of fraud because they documented that they provided intervention to a client on a specific date when in fact they did not. Making an honest error on the date of service is one thing; creating fictional progress notes is another. Fraud investigators are trained to know the difference.

Steps in the OT Process - Intervention

Types of Docs - Attendance logs; progress flow sheets; Progress notes (SOAP, DAP, or narrative); Contact notes; Transition plans

Steps in the OT Process - Outcomes; Discontinuation (discharge)

Types of Docs - Discharge summaries

Steps in the OT Process - Initial evaluation

Types of Docs - Evaluation reports or evaluation summaries

Steps in the OT Process - Follow-up

Types of Docs - Follow-up notes; contact notes

Steps in the OT Process - Intervention planning

Types of Docs - Intervention plans (also called a plans of care)

Steps in the OT Process - Screening (if required)

Types of Docs - Screening reports; contact notes

Steps in the OT Process - Client Identification

Types of Documentation - Referral or physician's orders; Contact notes

Steps in the OT Process - Reevaluation (intervention review)

Types of Documentation - Revised intervention plans

There are 3 exceptions to the ARRA's breach of confidentiality definition. What are they?

Unintentional access or use of protected health information, inadvertent disclosure of protected health information, and if the receiver of the impermissible disclosure is believed to not be able to retain or use the information

Fundamentals of Documentation - Abbreveiations

Use only abbreviations approved by the facility. There is usually a list that is used by all disciplines. Some common abbreviations are listed in Chapter 3 of this book. However, just because an abbreviation is listed in this book does not mean that it will be recognized at your facility or in your program

Summary - Chapter 10, Plagiarism

When you plagiarize, you not only cheat the originator of the material out of his or her proper credit, but also you cheat yourself by not really learning the material. Occasional honest mistakes can usually be tolerated but repeated instances of the same type of error in citing sources could be used to show a pattern of carelessness that amounts to plagiarism. A student who plagiarizes can expect to fail the assignment or the course, or be expelled from the program. Blatant and repeated plagiarism can lead to expulsion from a school. Plagiarism done by a professional can result in loss of a job or even a career in occupational therapy. There are ways to prevent plagiarism. Allowing plenty of time to complete written work, learning how to properly cite sources, and summarizing or paraphrasing from memory are a few of the ways that plagiarism can be prevented.

Important things to note for OT's and confidentiality

While the AOTA can enforce these ethical standards only with AOTA members, an attorney could present these standards in court as representing prevailing community standards, regardless of whether the occupational therapy practitioner is a member of AOTA or not. Also the NBCOT Code of Conduct applies to all occupational therapy students who plan to take the NBCOT Certification Exam and to all practitioners who are registered or certified by NBCOT.

Should all documentation by an OT students be cosigned by their supervisor?

Yes, it shows that the supervisor has read the note

Does a client have a right to see what is written in their educational or clincial record?

Yes, the client or the client's guardian has the right to see what is written in the clinical or educational record. This is a good reason to choose your words carefully, to remain both objective and nonjudgmental. In some cases, a facility will have rules surrounding this - a nurse may have to be present to answer questions or a physician must sign a release.

In an institutional setting, the institution will have established policies regarding access to patient/client information. Do occupational therapists have to comply with these?

Yes, they must comply with these policies. These may vary somewhat from place to place, but generally all must be consistent with the language and requirements of HIPAA. Staff involved in direct caregiving, supervisors, medical records, personnel, billing personnel, and insurance representatives usually are allowed access to the client's record provided it is necessary for treatment, payment, or health care operations.

When you write anything on record that specifies a client's name, what are you responsible for?

You are ethically responsible for ensuring that the information remains confidential, which means that you take all reasonable precautions to make sure that only people who have permission to read the record actually read it..

How do you tell if something is general information and doesn't need to be cited?

You can call something common knowledge if you find the same information in five different sources, and each time the author did not document a source for it.

Over the last several years, Medicare has stepped up efforts to catch OT practitioners who attempt to ob tain Medicare reimbursement through fraud. If you know that someone else has commited fraud, what should you do?

You have an obligation to report it. If you do not, you could be charged with conspiracy to commit fraud. If you do report it, you could receive a reward under the Federal False Claims Act, 15% to 25% share of the money recovered by the government for damages, civil penalties, and treble damages. You have to not only report the crime, but substantially assist the DOJ in prosecuting the case.

Fair use

allows a person to use another person's copyrighted works under certain conditions. Under this, you may be able to use someone else's work if you do not profit from its use, you give credit to the originator of the work, and you only use part of the original work; however, there is no guarantee that following these rules will make it fair use. Best advice is to ask first and always assume that everything is copyrighted