Compliance 101

True or False: Under the False Claims Act, "knowing" means only having actual knowledge. - Answer False Which of the following is not an element of an effective compliance program? - Answer Ignoring unethical conduct All of the following billing activities are considered fraudulent, EXCEPT: - Answer 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? ...

Corporate Compliance Program(CCP) - Answer a formal, organizational-specific, and organization-wide initiative designed to uncover, prevent, and eliminate inappropriate activity in your health organization fraud and abuse - Answer with a CCP a facility will be able to detect? Benefits of a CCP - Answer -demonstrate commitment -provide accurate view of behavior relating to fraud and abuse -ID & prevent criminal & unethical conduct -improve quality of patient care -create...

Seven Elements of an Effective Compliance Program - Answer (1) Standards, Policies, and Procedures (2) Compliance Program Administration (3) Communication, Education, and Training (4) Monitoring and Auditing (5) Internal Reporting Systems (6) Discipline for Noncompliance (7) Investigation and Remediation Measures Effective Compliance and Ethics Program Components (Not All-Inclusive) - Answer (1) Code of conduct and relevant compliance policies and procedures (2) Oversight and...

"...it cannot be emphasized enough that the only thing worse than not having a policy is having a policy and not following it." This statement refers to which of the 7 Compliance Program Elements" a. code of conduct b. compliance administration (Officer/Committee) c. education d. monitoring and auditing e. reporting and investigating f. enforcement and discipline g. response and prevention - Answer a. code of conduct What demonstrate the organization's ethical attitu...