THE FACTS AND ONLY THE FACTS
This costs tax payers billions of dollars each year.
What is healthcare fraud, waste & abuse.
This act protects people from retaliation or retribution who report unethical or illegal behavior.
What is the Whistleblower's Act?
The person to contact at Macon Community Hospital if you have a compliance concern.
Who is the Compliance Officer(David Flynn)?
You are committing this if you bill for a service that you did not perform.
What is fraud?
OIG stands for...
What is the Office of Inspector General?
A set of guidelines that Macon Community Hospital outlines for ethical behavior for employees.
What is the Code of Conduct Policy HR.005.01?
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?
The person to contact at a Dignity Health facility if you feel your medical information has been accessed by someone who has no right to know about it.
Who is the Compliance Officer AND HIPPA Privacy Officer?
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?)
PHI stands for...
What is Protected Health Information?
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 Medical reimbursement.
What is a Compliance Program?
This is a criminal statute that prohibits the exchange (or offer to exchange), of anything of value, in an effort to induce (or reward) the referral of federal health care program business.
What is the Anti-Kickback Statute?
The person to contact at Macon Community Hospital if you feel pictures of a patient have been posted on the Internet without the patient's permission.
Who is the Compliance Officer?
Receiving a gift of nominal value in exchange for referrals.
What is a kickback?
HIPAA stands for...
What is Health Insurance Portability and Accountability Act?
Methods used by healthcare facilities to effectively detect & prevent fraud, waste & abuse.
What are monitoring & audits?
A legal document requesting testimony or records.
What is a subpoena?
Many health care facilities offer this compliance reporting method to allow people to report anonymously.
What is a compliance hotline?
Regular reviews performed as part of normal operations to confirm ongoing compliance. These are day-to-day functions.
What is monitoring?
CMS stands for...
What is the Center for Medicare and Medicaid Services?
The people responsible for ensuring a healthcare facility acts responsibly & ethically.
Who are all employees?
Prohibits physician self-referral for Medicare and Medicaid patients.
What is Stark Law?
The ways in which to report a compliance concern at Macon Community Hospital.
What are in-person, email, phone call, online report internally, Navex Hot-Line call
Once a compliance concern is discovered, the time frame within which it should be reported.
What is immediately?
ACA stands for...
What is the Affordable Care Act?