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