Fraud, Waste, and Abuse for 2023 Questions And Answers

Fraud, Waste, and Abuse for 2023 Questions And Answers Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper Management only. - ANS False Ways to report a compliance issue include: a. Telephone hotlines b. Report on the Sponsor's website c. In-person reporting to the compliance department/supervisor d. All of the above - ANS d. All of the above What is the policy of non-retaliation? a. Allows the Sponsor to discipline employees who violate the Code of Conduct b. Prohibits management and supervisor from harassing employees for misconduct c. Protects employees who, in good faith, report suspected non-compliance d. Prevents fights between employees - ANS c. Protects employees who, in good faith, report suspected non-compliance 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. - ANS True 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. - ANS False Medicare Parts C and D plan Sponsors are not required to have a compliance program. - ANS False At a minimum, an effective compliance program includes four core requirements. - ANS False Standards of Conduct are the same for every Medicare Parts C and D Sponsor. - ANS False Correcting non-compliance ________________. a. Protects enrollees, avoids recurrence of the same non-compliance, and promotes efficiency b. Ensures bonuses for all employees c. Both A and B - ANS a. Protects enrollees, avoids recurrence of the same non-compliance, and promotes efficiency