You Will Learn
General Compliance Training
After completing this module, you will be able to:
- Recognize how a compliance program operates
- Identify and explain each of the seven core elements of a compliance program required by the Centers for Medicare and Medicaid Services (CMS):
-Written polices, procedures, and standards of conduct
-Compliance officer, compliance committee, and high-level oversight
-Effective training and education
-Effective lines of communication
-Well publicized disciplinary standards
-Effective system for routine monitoring, auditing, and identifying compliance risks
-Procedures for prompt response to compliance issues - Recognize the importance of conducting yourself in an ethical and legal manner
- Gain an understanding of how your organization’s Standards of Conduct can be used to guide your behavior in specific situations
- Understand what is meant by non-compliance
- Identify non-compliance risk situations
- List four potential consequences of non-compliance including contract termination
- Understand how non-compliance adversely impacts everyone including healthcare beneficiaries
- Recognize how compliance program violations should be reported
- Understand what happens after non-compliance is detected including the need for both internal monitoring and audits
Question 1
Complete
What are some of the consequences for non-compliance, fraudulent, or unethical behavior?
Question 1Select one:
a.
Disciplinary action
b.
Termination of employment
c.
Exclusion from participating kin all Federal health care programs
d.
All of the above
Question 2
Complete
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.
Question 2Select one:
a.
True
b.
False
Question 3
Complete
Ways to report a compliance issue include:
Question 3Select one:
a.
Telephone hotlines
b.
Report on the Sponsor’s website
c.
In-person reporting to the compliance department/supervisor
d.
All of the above
Question 4
Complete
Once a corrective action plan begins addressing non-compliance for 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.
Question 4Select one:
a.
True
b.
False
Question 5
Complete
At a minimum, an effective compliance program includes four core requirements.
Question 5Select one:
a.
True
b.
False
Question 6
Complete
Correcting non-compliance________
Question 6Select one:
a.
Protects enrollees, avoids recurrence of same non-compliance, and promotes efficiency
b.
Ensures bonuses for all employees
c.
Both A and B
Question 7
Complete
Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper Management only.
Question 7Select one:
a.
True
b.
False
Question 8
Complete
Standards of Conduct are the same for every Medicare Parts C and D sponsor.
Question 8Select one:
a.
True
b.
False
Question 9
Complete
Medicare Parts C and D sponsors are not required to have a compliance program.
Question 9Select one:
a.
True
b.
False
Question 10
Complete
What is the policy of non-retaliation?
Question 10Select one:
a.
Allows the Sponsor to discipline employees who violate the Code of Conduct
b.
Prohibits management and supervisors from harassing employees for misconduct
c.
Protects employees, who in good faith report suspected non-compliance
d.
Prevents fights between employees