Banner Corporate Compliance (CIA Vendor) Exam

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In 2018, Banner agreed to pay the United States over $18 million.

True

A business associate offers to cover your travel expenses in exchange for an annual contract with Banner

Accept reimbursement of travel expenses if it does not unduly influence any business decisions of Banner.

An outside business associate generously offers you a gift. What is the policy in regards to accepting an item from an outside business associate?

An item cannot be accepted from an outside business associate. If offered, given, requested, or accepted in exchange for or to induce referrals or other business that may be reimbursed by a Federal health care program

Includes any request or demand for money (such as a bill for medical services) that is submitted to the U.S. government or its contractors.

Claim

Banner prohibits retaliation against any individual who reports a potential violation

False

You must disclose your name when calling the ComplyLine

False

Violated when a person "knowlingly" makes or uses a false record or statement to get a false or fraudulent claim paid or approved by the Federal Government.

Federal False Claims Act

States that: "Whoever knowingly and willfully executes, or attempts to execute, a scheme to defraud any health care benefit program shall be fined under this title or imprisoned not more than 10 years, or both."

Health Car Fraud Statute

Includes patents, trademarks, service marks, trade secrets, copyrights, proprietary information and inventions or techniques

Intellectual Property

You often recommend your spouse's services to your clients even though it may shift business away from Banner Health. Is this an appropriate action on your part?

It is not appropriate because it is considered a conflict of interest.

A provision that allows any person with actual knowledge of false claims activity to file a lawsuit in federal court on behalf of the federal government without fear of retaliation

Qui Tam

For the first time this year, an Outside Business Associate offers to take you to dinner to discuss business. Can you:

Say no, because informal gathers are strictly prohibited.

You may invite employees to a sponsored event if:

The event takes place outside of business hours

Abuse involves paying for items or services when there is no legal entitlement to that payment

True

Banner's Corporate Integrity Agreement is available for you to read on the OIG website.

True

ComplyLine is available 24 hours a day, seven days a week and is confidential

True

New compliance personnel, policies, procedures, and processes were required under the CIA

True

People who fail to detect, report, and/or correct any offense are subject to corrective action

True

The Iro conducts a claims review and short stay review each year at certain covered facilities. There is currently no screening process for Covered Persons prior to engaging their services.

True

There are many avenues where you can obtain guidance or report a compliance issue

True

There is only one Area Compliance Program Director

True

You are considering accepting a personal loan from one of Banner's suppliers. What is your next step?

You decide not to accept the loan due to issues of financial interest.

You are offered an expensive vacation opportunity in exchange for a contractor's services. What do you do?

You never ask for or provide gifts in response to a request

It is important that you recognize actions that constitute fraud, waste, and abuse. Read the question and decide if the best answer is Yes or No: Is altering forms, records, or receipts to receive a higher payment examples of fraud, waste, or abuse?

Yes

It is important that you recognize actions that constitute fraud, waste, and abuse. Read the question and decide if the best answer is Yes or No: Is conducting excessive office visits or writing excessive prescriptions examples of fraud, waste, or abuse?

Yes

It is important that you recognize actions that constitute fraud, waste, and abuse. Read the question and decide if the best answer is Yes or No: Is knowingly billing Medicare for appointments the patient failed to keep an example of fraud, waste, or abuse?

Yes

It is important that you recognize actions that constitute fraud, waste, and abuse. Read the question and decide if the best answer is Yes or No: Is prescribing more medications than necessary for treatment an example of fraud, waste, or abuse?

Yes

It is important that you recognize actions that constitute fraud, waste, and abuse. Read the question and decide if the best answer is Yes or No: Is unknowingly billing for brand name drugs when generics are dispensed an example of fraud, waste, or abuse?

Yes

It is important that you recognize actions that constitute fraud, waste, and abuse. Read the question and decide if the best answer is Yes or No: Is unknowingly misusing codes on a claim an example of fraud, waste, or abuse?

Yes


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