Fraud, Waste And Abuse For 2023 – Qs & As
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
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