Question

These are examples of issues that should be reported to a Compliance Department: suspected Fraud and Abuse (FA); potential health privacy violation, and unethical behavior/employee misconduct.

Answer 1

The statement 'Fraud, Abuse, potential health privacy violation and unethical behavior are examples of issues that should be highlighted to compliance department' is True.

A successful compliance program promotes a compliance culture within an organization. For an effective compliance program it is necessary to

1. Prevents, detects and corrects non-compliance.
2. Is fully implemented and customized to an organization's particular operations and circumstances.
3. Has sufficient resources
4. Promotes the Organization's Standards of Conduct
5. Establishes clear channels of communication for reporting non-compliance.

To avoid, identify, and address noncompliance as well as Fraud, Waste, and Abuse, an efficient compliance program is necessary (FWA). Non-compliance has an impact on everyone. Without tools it is difficult to prevent and everyone is at stake.

In case of unethical behavior or employee misconduct the organization can take following actions

• Exclusion from all Federal health care programs
• Discipline
• Termination

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