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Compliance Program, Exclusion Screening, and Fraud Prevention

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.

Preview: full text with a package
About this policy
Policy number
FL-HH-ETH-01
Version
1.0
Main rule
s. 409.913, F.S.
Library
Florida home health · 57 policies
Category
Ethics
Sections
20

In short

  • 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.

What's inside

20 sections. The full text comes with the One-time Policy Pack.

Full text with a package
  • 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

An inspector may ask

  • 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.

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