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What is the False Claims Act? When was it amended? - Precise Answer
✔✔-Legislation that prohibits anyone from knowingly submitting or
causing to be submitted a false or fraudulent claim.
-It allows individuals to file lawsuits on behalf of the U.S. Government
and may receive a portion of the government's recovery.
-1986.
What are the U.S Federal Sentencing Guidelines?
When was the Federal Sentencing Commission Organized?
When were the Guidelines first published?
When were the Guidelines Amended?
And what did the amendment include? - Precise Answer ✔✔Guidelines
developed by the US. Federal Sentencing Commission that set out a
uniform policy for sentencing individuals and organizations of felonies
and serious misdemeanors.
- 1985.
- Published in 1987.
-Amended in 1991 - Included 7 elements of a Compliance Program.
,What Chapter of the U.S Federal Sentencing Guidelines focuses on
compliance programs for organizations? - Precise Answer ✔✔Chapter
8.
What are the 7 elements of a compliance program? - Precise Answer
✔✔1. Policies & Procedures.
2. Program Administration - Compliance Officer & Committee.
3. Training & Education.
4. Effective Lines of Communication.
5. Internal Monitoring & Auditing.
6. Disciplinary Guidelines.
7. Corrective Action.
What is a Corporate Integrity Agreement? - Precise Answer ✔✔A
negotiated settlement between an organization and the government in
which the provider accepts no liability but must agree to implement a
strict plan of government-supervised corrective action.
What is the Health Care Fraud and Abuse Control Program?
When was it established?
What law mandated its creation? - Precise Answer ✔✔It's a program
that coordinates federal, state, and local law enforcement activities to
combat fraud and abuse in the healthcare sector.
1997.
,HIPAA.
HHS OIG issued "Practical Guidance for Health Care Governing Boards
on Compliance Oversight" in what year?
What law outlined the use of exclusion from federal health programs? -
Precise Answer ✔✔2015.
Social Security Act.
OIG and HCCA issued "Measuring Compliance Program Effectiveness -
A Resource Guide" in what year? - Precise Answer ✔✔2017.
What are the benefits of a compliance program? - Precise Answer ✔✔*
Good corporate conduct and quality of care.
* Protects patient rights and privacy.
* Detects criminal and unethical conduct.
* Centralized resource for info. on healthcare regulations.
* Encourages reporting w/o retaliation.
* Allows for prompt/thorough investigations.
* Initiates in RCAs and CAPs.
* Reduces exposure to:
-civil damages and penalties
, -sanctions
-administrative remedies.
-CIAs and government exclusions
Why are effective compliance programs essential? - Precise Answer
✔✔1. Protect the organization's reputation.
2. "Doing the right thing."
3. Raise awareness - employees can report anonymously.
4. Keeps employees accountable.
5. Detect non-compliance early and reduce risk of fines and penalties.
More reasons to implement a compliance program! - Precise Answer
✔✔* Demonstrate commitment to honesty/corporate citizenship.
* Cost-effective.
* Provides procedures to identify and correct misconduct.
* May protect corporate directors from liability.
What are the risks of not having a compliance program? - Precise
Answer ✔✔1. Increased threat of qui tam lawsuits.
2. Government may impose:
a. CIAs
b. settlements
c. consent decrees
d. exclusions
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