Fraud, Waste, and Abuse for 2023 Questions and Answers with complete solution

Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper Management only. - 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 - 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 - 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. - 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. - False Medicare Parts C and D plan Sponsors are not required to have a compliance program. - False At a minimum, an effective compliance program includes four core requirements. - FalseStandards of Conduct are the same for every Medicare Parts C and D Sponsor. - 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 - a. Protects enrollees, avoids recurrence of the same non-compliance, and promotes efficiency What are some of the consequences for non-compliance, fraudulent, or unethical behavior? a. Disciplinary action b. Termination of employment c. Exclusion from participation in all federal health care programs d. All of the above - d. All of the above