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