Who is it?
Immediate supervisor, department head, HR, compliance, through a Compliance Issue Report, or through the TrustLine
Who can you report compliance concerns/violations/non-compliance to?
You are committing this if you bill for a service that you did not perform
What is fraud?
Individuals’ health information that is private and protected
What is PHI, or Protected Health Information?
IDOI
What is the Indiana Department of Insurance?
The year legislation was passed to create the
Medicaid program
What is 1965?
The IU Health Plans HIPAA Security Officer
Who is Joan Naffziger?
It’s a violation of policy to do this when you are aware of fraudulent activity or non-compliance
What is nothing?
Acronym for the 1996 law that has a Privacy Rule and a Security Rule
What is HIPAA?
ERISA
What is Employee Retirement Income Security Act?
It Didn’t Happen
What is If It’s Not Written Down?
The IU Health Plans HIPAA Privacy Officer
Who is Merri Beth Lavagnino?
Receiving a large gift in exchange for referrals
What is a kickback?
Set of standardized performance measures developed by the NCQA
What is HEDIS, or the Healthcare Effectiveness Data and Information Set?
FDR
What is a First Tier, Downstream or Related Entity?
The best Hoosier owned health insurance plan in Indiana
What is Indiana University Health Plans?
Our Compliance Officer
Who is Tina Korty?
Set of written guidelines which outline ethical behavior for all employees to abide by
What is the Code of Conduct?
PPACA
What is the Patient Protection and Affordable Care Act?
OIG/GSA
What is the Office of the Inspector General and General Services Administration?
Members that are qualified to be both in Medicare and Medicaid
What is dually eligible?
The internal entity that the Compliance Officer reports issues of non-compliance to
Who is the Board of Directors?
Overutilization of services, or other practices that, directly or indirectly, result in unnecessary costs to the Medicare program
What is Waste?
Name, Social Security number, driver’s license number, financial account number
What is PII or Personally Identifiable Information?
IC
What is the Indiana Code?
This President signed the Medicare and Medicaid Acts
Who is Lyndon B. Johnson?