Medicare and Medicaid General Compliance Training
What are some of the consequences for non-compliance, fraudulent, or unethical behavior?
Disciplinary action Termination of employment Exclusion from participation in all Federal health care programs
At a minimum, an effective compliance program includes four core requirements.
False
Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper Management only.
False
Medicare Parts C and D plan Sponsors are not required to have a compliance program.
False
Once a corrective action plan begins addressing non-compliance or Fraud, Waste, and Abuse (FWA) committed by a Sponsor's employee or First-Tier, Downstream, or Related Entity's (FDR's) employee, ongoing monitoring of the corrective actions is not necessary
False
Standards of Conduct are the same for every Medicare Parts C and D Sponsor.
False
What is the policy of non-retaliation?
Protects employees who, in good faith, report suspected non-compliance
Correcting non-compliance ______________.
Protects enrollees, avoids recurrence of the same non-compliance, and promotes efficiency
Ways to report a compliance issue include: Select the correct answer.
Telephone hotlines Report on the Sponsor's website In-person reporting to the compliance department/supervisor
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.
True