This costs tax payers billions of dollars each year.
What is healthcare fraud, waste & abuse?
100
This act protects people from retaliation or retribution who report unethical or illegal behavior.
What is the Whistleblower's Act?
100
The person to contact at a healthcare facility if you have a compliance concern.
Who is the Compliance Officer?
100
You are committing this if you bill for a service that you did not perform.
What is fraud?
100
OIG
What is the Office of Inspector General?
200
A set of guidelines that outlines ethical behavior for employees.
What is the Code of Conduct?
200
This makes it illegal for people to submit false statements or documentation in order to collect money from the government.
What is the False Claims Act?
200
The person to contact at a healthcare facility if your feel your medical information has been accessed by someone who has no right to know about it.
Who is the HIPAA Privacy Officer?
200
It's a violation of the Compliance Policy to do this when you are aware of fraudulent activity.
What is nothing? (What is to not report it?)
200
PHI
What is Protected Health Information?
300
Developed by a healthcare facility because it's right to set high ethical standards, and because it's mandatory for facilities receiving Medicare, Medicaid and/or CHIP reimbursement.
What is a Corporate Compliance Program?
300
This law makes it a crime to improperly avoid the obligation to pay back money owed to the Government. It prohibits improper retention of overpayment, once discovered.
What is the Fraud Enforcement and Recovery Act, or "FERA?"
300
The person to contact at a healthcare facility if photos of a patient have been posted on the internet without the patient's permission.
Who is the HIPAA Security Officer?
300
Receiving a large gift in exchange for referrals.
What is a kickback?
300
Regular reviews performed as part of normal operation to confirm ongoing compliance. These are day-to-day functions.
What is a monitoring?
400
Used by healthcare facilities to effectively detect and prevent fraud, waste and abuse.
What are monitoring and audits?
400
A legal document requesting testimony or records.
What is a subpoena?
400
Many health care facilities offer this compliance reporting method to allow people to report anonymously.
What is a compliance hotline?
400
Identification required when reporting a compliance concern at most healthcare facilities.
What is none because may report anonymously?
400
CMS
What is the Center for Medicare and Medicaid Services?
500
The people responsible for ensuring a health care facility acts responsibly and ethically.
Who are all employees?
500
A written mandate from a judge compelling production of records or other items of evidence.
What is a court order?
500
The ways in which to report a compliance concern to the Compliance Officer.
What are in-person, by writing, by phone call or anonymously?
500
Once a compliance concern is discovered, the time frame within which it should be reported.