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