{"ref":"TX-HH-ETH-02","title":"Compliance Program, Exclusion Screening, and Fraud Prevention","category":"Ethics","summary":"Sets out the Agency’s compliance program: written standards and a code of conduct, a compliance officer, training, a safe way to report concerns, monthly exclusion screening, auditing, prompt correction and repayment, and protection for anyone who reports in good faith.","inShort":["Document only what you did, when you did it. Never back-date or sign for someone else.","Report any concern about billing, records, or conduct to the compliance officer, Pat Sample, at (512) 555-0100.","If the concern is about the Administrator, contact Jo Sample. You may report anonymously.","You will never be punished for reporting in good faith.","Tell the compliance officer at once if you are excluded from Medicare or Medicaid or your license is affected."],"primaryCitation":"1 TAC §371.1655","citations":["1 TAC §371.1655","Tex. Hum. Res. Code ch. 36","Tex. Hum. Res. Code §36.115","26 TAC §558.254"],"federalCitations":["42 U.S.C. §1396a(a)(68)","31 U.S.C. §3729","42 U.S.C. §1320a-7b(b)","42 U.S.C. §1320a-7a","42 U.S.C. §1320a-7k(d)","42 CFR §401.305","42 CFR §1001.1901","42 CFR §484.65(e)(4)","42 CFR §484.105(e)(2)"],"surveyorAsks":["Who is your compliance officer, and how does a nurse or aide report a concern without going through their supervisor?","Show me your exclusion screening for this month for every employee and contractor, and what you would do with a match."],"forms":[{"ref":"TX-HH-ETH-02-A","title":"Code of Conduct and Compliance Acknowledgment"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (1 TAC §371.1655)","5. Compliance Officer and Governing Body Oversight","6. Code of Conduct","7. Reporting a Concern","8. Exclusion Screening, Auditing, and Monitoring","9. Investigating, Correcting, and Repaying","10. Federal and State False Claims Laws","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":"tx-lhhs","state":"Texas","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 Home Health Agency","legalName":"Sample Home Health Agency, LLC","logo":null}}