{"ref":"CA-HH-ETH-01","title":"Compliance Program, Exclusion and Suspended Provider Screening, and False Claims Prevention","category":"Ethics","summary":"Sets up the Agency’s compliance program: a code of conduct, a compliance officer, training, ways to report concerns without retaliation, monthly screening of every employee, contractor, owner, and governing body member against the federal exclusion list and the Medi-Cal Suspended and Ineligible Provider List, investigation and correction, and education about the federal and California false claims laws.","inShort":["Be honest in every note, timesheet, and claim.","Report any concern about fraud, abuse, or breaking the rules to your supervisor, the compliance officer, or the government. You can report anonymously.","No one is punished for reporting in good faith.","We check every worker every month against the federal and Medi-Cal exclusion lists. Tell us at once if you are ever excluded or suspended.","Never handle a patient’s money or accept gifts beyond a small token."],"primaryCitation":"Cal. Welf. & Inst. Code §14043.61","citations":["Cal. Welf. & Inst. Code §14043.61","Cal. Welf. & Inst. Code §14123","Cal. Health & Safety Code §1735(f)","Cal. Gov. Code §12651","Cal. Gov. Code §12653","Cal. Lab. Code §1102.5"],"federalCitations":["42 CFR §1001.1901","42 U.S.C. §1396a(a)(68)","31 U.S.C. §3729","42 CFR §484.65(e)(4)","42 CFR §484.105(e)(2)","42 CFR §401.305"],"surveyorAsks":["Who is your compliance officer, and how do staff reach them?","Show me your exclusion screening for last month. Which lists did you check?"],"forms":[{"ref":"CA-HH-ETH-01-A","title":"Code of Conduct and Compliance Acknowledgment"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (Cal. Welf. & Inst. Code §14043.61)","5. Elements of the Compliance Program","6. Exclusion and Suspension Screening","7. Reporting Concerns and Non-Retaliation","8. Investigations and Corrective Action","9. False Claims Education","10. Code of Conduct","11. Responsibilities","12. Records and Compliance Monitoring","13. Staff Training","14. References","15. Related Policies and Forms","16. Approval","17. Revision History"],"version":"1.0","sample":false,"pack":"ca-hha","state":"California","service":"Home health","guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}