Medicare parts c and d general compliance

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 same non-compliance, and promotes efficiency

You discover an unattended email address or fax machine in your office that receives beneficiary appeals requests. You suspect that no one is processing the appeals. What should you do?

contact your compliance department (via compliance hotline or other mechanism)

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 committed by a Sponsors employee or FDR employees, 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

You are performing a regular inventory of the controlled substances in the pharmacy. You discover a minor inventory discrepancy. What should you do?

follow your pharmacy's procedures

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

What are some of the consequences for non-compliance, fraudulent, or unethical behavior?

A: all of the above Disciplinary action; Termination of employment; Exclusion from participation in all Federal health care programs

Ways to report a compliance issue include:

A: all of the above telephone hotlines; Report on the Sponsors website; In-person reporting to the compliance department/supervisor