Policies and Procedures
This policy states that it is to prevent fraud, waste, and abuse.
What is Corporate Compliance Policy
855-222-0629 is the number for this type of reporting method?
What is Anonymous/hotline reporting
The time frame in which newly hired staff need to be trained in the RSS Organizational Experience and Risk Areas training as regulated by the Office of Medicaid Inspector General
What is within 60 days of hire or appointment
This group of people consist of all employees, chief executives, senior administrators, managers, contractor, agents, subcontractors, indepenendent contractors and governing body, and corporate officers
What are Affected Individuals
This should be done if a coworker asks you to document a service they provided because they are busy
Refuse to sign or document services you did not provide and report the situation to your supervisor.
This policy states it is to protect the privacy and confidentiality of individuals served to the fullest extent of federal/state law and regulation.
What is the Confidentiality policy
The Compliance Department has this dedicated email to make reports
What is the Compliance Privacy Email
The time frame in which newly hired staff need to be trained in Ethics and Corporate Compliance as regulated by the Office of Medicaid Inspector General
What is within 30 days of hire or appointment
This title is given to the person responsible for overseeing the agencies Compliance Program
What is the Compliance Officer
You should do this if you overhear staff discussing a client's treatment in a public area.
Remind staff to stop the conversation and report the privacy concern to a supervisor
This policy states that all Affected Individuals are required to report any suspected fraud, waste, or abuse or other improper activity as soon as they become aware of it.
What is Fraud, Waste, and Abuse Reporting Policy
You can report directly to this person with any compliance concerns or reports of compliance misconduct
Who is Julie Fournier
What specific program related training upon hire and annually for each program type is necessary, if applicable
What is documentation, and claim development and submission (billing) training
Billings, payment, ordered services, medical necessity, quality of care, governance, mandatory reporting, credentialing, contractor oversight, and HIPAA security are all considered what?
What is Compliance Risk Areas
You should do this if you accidentally send client information to the wrong email recipient
Notify your supervisor and Privacy/Compliance Officer immediately and follow breach reporting procedures
This policy states that RSS will not employ, contract with or conduct business with an individual or entity excluded from participation in federal/state funded programs such as Medicare and Medicaid
What is the Exclusion and Sanction Screening policy
This group of RSS staff can also receive reports of potential compliance related issues
What are your immediate supervisor, Managing Director, or anyone in the RSS Administration
One goal of compliance education is to help staff identify and report these
What are compliance concerns, violations, or potential fraud, waste, and abuse
Violation of Code of Conduct Section C-20, failure to complete required trainings, and violation of RSS IT Policies all hold this
What is Disciplinary Standards
You should do this if another staff member shares their login credentials with you.
Do not use their credentials. Report the issue and use only your assigned account.
This policy states that Affected Individuals who, upon investigation are found to have committed compliance violations are subject to disciplinary action up to, and including termination of employment, contract, assignment or appointment.
What is the Discipline and Enforcement of Compliance Standards policy
This will result in disciplinary action, up to and including termination or in the case of non-RSS employees, termination of a relationship or contract as all affected individuals have a duty to report
What is failing to report a suspected violation of law, rules, regulations or guidelines
This is required for all affected others to help them understand compliance laws, regulations, and agency policies.
What is annual compliance training
You are in violation of this, if you knowingly submit, or cause to submit, false claims to the government
What is the False Claims Act
You should do this if you suspect a coworker may be documenting services they did not provide.
Report the concern through the chain of command or compliance reporting process. Do not investigate on your own.