Relias: Ethics and Corporate Compliance

_______ are practices that are inconsistent with sound fiscal, business, or medical practices resulting in unnecessary costs and improper payment.

Abuse

What is fraudulent conduct?

Acting in a manner that knowingly deceives someone for financial benefit

Which of the following is an example of billing fraud?

Billing for services that are not medically necessary

Lucy confides to you that a coworker has been sexually harassing her. She wonders if this is something that would fall under improper conduct in the compliance program. What should you tell her?

Compliance programs address all types of improper conduct.

Which of the following is a high-risk area for improper or fraudulent conduct?

Documentation

Which of the following describes fraudulent conduct?

Documenting care that did not occur

__________ defines what is morally right and wrong.

Ethics

True or False: Under the False Claims Act, "knowing" means only having actual knowledge.

False

Which of the following is not an element of an effective compliance program?

Ignoring unethical conduct

The purpose of corporate compliance programs are to:

Prevent, detect, and correct all unlawful and unethical conduct

What types of gifts or favors are acceptable under a compliance program?

Receiving a coffee mug with your organization's logo on it

Your supervisor comes to you and asks you to document something that did not occur. What should you do?

Report the supervisor's request.

Which of the following describes a whistleblower?

Someone who calls attention to wrongdoing

All of the following billing activities are considered fraudulent, EXCEPT:

Submitting bills for goods or services as provided

A vendor tells you that you have won an all-expense paid trip to the Bahamas no strings attached. What should you do?

Talk to your compliance officer about the gift.

The Anti-Kickback Statute applies to compensation of any kind not just cash.

True

True or False: Abuse, waste, fraud, and kickbacks are types of improper or fraudulent conduct.

True

When you honestly report a potential compliance violation you are legally protected against retaliation.

True