{"ref":"FL-HC-ETH-02","title":"Compliance Program, Referral Practices, and Fraud Prevention","category":"Ethics","summary":"Establishes the Agency's compliance program: a compliance officer, written standards, training, a way to report concerns without retaliation, monthly exclusion screening, auditing, and corrective action; and prohibits the referral payments, gifts to beneficiaries, free staffing, patient brokering, kickbacks and false records and billing that Florida and federal law forbid.","inShort":["We never pay or give gifts to doctors, discharge planners or facility staff for referrals.","We never give cash or gift cards to Medicare or Medicaid clients.","Record only what you actually did and saw. Never chart ahead or sign for someone else.","Report any concern about fraud or kickbacks to Pat Sample or the governing body. You can report anonymously, and you are protected from retaliation.","We check every staff member against federal and Florida exclusion lists every month."],"primaryCitation":"s. 400.474(6), F.S.","citations":["s. 400.474(2)(d), (4), (6), F.S.","s. 400.518(4), F.S.","s. 400.462(13), (30), F.S.","s. 400.471(8), F.S.","s. 817.505, F.S.","s. 456.054, F.S.","s. 408.810(2), F.S.","s. 408.815(1)(e), (4), F.S.","s. 409.913, F.S."],"federalCitations":["42 U.S.C. §1320a-7b(b)","42 CFR §1001.1901","31 U.S.C. §3729","31 U.S.C. §3730(h)"],"surveyorAsks":["Who is your compliance officer, and how do staff report a concern?","How often do you check staff against exclusion lists, and which lists?"],"forms":[{"ref":"FL-HC-ETH-02-A","title":"Exclusion Screening and Compliance Log"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (s. 400.474(6), F.S.)","5. Elements of the Compliance Program","6. Prohibited Referral Practices","7. Medical Director","8. Accurate Records and Billing","9. Exclusion Screening","10. Auditing and Monitoring","11. Reporting and Investigation","12. Correcting Problems","13. Consequences for the License","14. Responsibilities","15. Records and Compliance Monitoring","16. Staff Training","17. References","18. Related Policies and Forms","19. Approval","20. Revision History"],"version":"1.0","sample":false,"pack":"fl-hca","state":"Florida","service":"Home care","guides":[{"path":"/guides/home-care-agency-policies/","h1":"What policies does a home care agency need?"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}