Fraud, Waste, and Abuse for 2023 Best of Questions & Answers

Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper Management only. - Answer 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 - Answer 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 - Answer 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. - Answer 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. - Answer False Medicare Parts C and D plan Sponsors are not required to have a compliance program. - Answer False At a minimum, an effective compliance program includes four core requirements. - Answer False Standards of Conduct are the same for every Medicare Parts C and D Sponsor. - Answer False Correcting non-compliance ________________.