Compliance Program, Exclusion Screening, and False Claims
Sets up the Agency's compliance program: a responsible person, written standards, training, a way to report concerns without retaliation, screening of staff and contractors against the federal exclusion list and the Medi-Cal Suspended and Ineligible Provider List before hire and monthly, and prompt correction and repayment when a problem is found.
About this policy
- Policy number
- CA-HC-ETH-03
- Version
- 1.0
- Main rule
- Cal. Welf. & Inst. Code §14043.61
- Library
- California home care · 50 policies
- Category
- Ethics
- Sections
- 17
In short
- Everyone who works for the Agency is checked against the federal and Medi-Cal exclusion lists.
- Bill only for services that were actually delivered and documented.
- Never offer or accept anything of value for client referrals.
- Report any concern about fraud to the Administrator, or anonymously.
- You are protected from retaliation when you report in good faith.
What's inside
17 sections. The full text comes with the One-time Policy Pack.
- 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 Screening
- 7. Claims, Referrals and Inducements
- 8. Responding to a Problem
- 9. Protection for People Who Report
- 10. Responsibilities
- 11. Records and Compliance Monitoring
- 12. Staff Training
- 13. References
- 14. Related Policies and Forms
- 15. Approval
- 16. Revision History
An inspector may ask
- Who is responsible for compliance in your agency?
- Show me your exclusion screening log for the last three months.
See Cura Core with your agency's name on it.
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