Medicare and Medicaid General Compliance Training Medicare and Medicaid General Compliance Training

Medicare and Medicaid General Compliance Training
Ways to report a compliance issue include:

Select the correct answer. - ANS Telephone hotlines

Report on the Sponsor's website
In-person reporting to the compliance department/supervisor
Medicare Parts C and D plan Sponsors are not required to have a compliance program. - ANS
False
At a minimum, an effective compliance program includes four core requirements. - ANS 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 - ANS False
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. - ANS True
Standards of Conduct are the same for every Medicare Parts C and D Sponsor. - ANS False
What are some of the consequences for non-compliance, fraudulent, or unethical behavior? -
ANS Disciplinary action
Termination of employment
Exclusion from participation in all Federal health care programs
What is the policy of non-retaliation? - ANS Protects employees who, in good faith, report
suspected non-compliance
Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper
Management only. - ANS False
Correcting non-compliance ______________. - ANS Protects enrollees, avoids recurrence of
the same non-compliance, and promotes efficiency