{"ref":"FL-HH-ETH-01","title":"Compliance Program, Exclusion Screening, and Fraud Prevention","category":"Ethics","summary":"Sets up the Agency's compliance program: a compliance officer, a code of conduct, training, a way to report concerns without retaliation, monthly screening of staff and contractors against exclusion lists, auditing, investigation, and correction, together with the Florida and federal false claims and Medicaid fraud laws staff must know.","inShort":["Document honestly and bill only for care that was given.","Report any concern about fraud, waste, or abuse to your supervisor or to Pat Sample. You can report anonymously.","The Agency never punishes anyone for reporting a concern in good faith.","We check every staff member against federal exclusion lists every month."],"primaryCitation":"s. 409.913, F.S.","citations":["s. 408.810(2), F.S.","s. 409.913(7), F.S.","s. 409.920, F.S.","s. 68.082, F.S.","s. 400.474(2)(d), F.S.","s. 408.809(4), F.S.","s. 408.810(5)(a), F.S.","s. 400.494(2), F.S."],"federalCitations":["42 U.S.C. §1320a-7","42 CFR §1001.1901","31 U.S.C. §3729","42 U.S.C. §1396a(a)(68)","42 CFR §484.65(e)","42 CFR §484.105(e)"],"surveyorAsks":["Who is your compliance officer? How does a staff member report a concern?","Show me your exclusion screening for staff and contractors for the last three months."],"forms":[{"ref":"FL-HH-ETH-01-A","title":"Exclusion and Sanction Screening Log"},{"ref":"FL-HH-ETH-01-B","title":"Code of Conduct and Compliance Acknowledgment"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (s. 409.913, F.S.)","5. Compliance Officer and Governing Body Oversight","6. Code of Conduct","7. Exclusion Screening","8. Reporting Concerns and Non-Retaliation","9. Auditing and Monitoring","10. Investigation and Corrective Action","11. Exclusions on License Applications","12. False Claims Laws Education","13. Responsibilities","14. Records and Compliance Monitoring","15. Staff Training","16. References","17. Related Policies and Forms","18. Approval","19. Revision History"],"version":"1.0","sample":false,"pack":"fl-hha","state":"Florida","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}}