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Compliance Program, Exclusion Screening, and Fraud Prevention

Sets out the Agency's compliance program: oversight, a code of conduct, ways to report concerns without retaliation, monthly exclusion screening of staff and contractors, auditing and monitoring, investigation and correction, education on the federal False Claims Act and the Louisiana Medical Assistance Programs Integrity Law, and cooperation with government investigations.

Preview: full text with a package
About this policy
Policy number
LA-HH-ETH-01
Version
1.0
Main rule
R.S. 46:438.3
Library
Louisiana home health · 57 policies
Category
Ethics
Sections
20

In short

  • Document only the care you gave, and never change or back-date a record.
  • Report any concern about fraud, waste or abuse. You will not be punished for reporting in good faith.
  • We check every employee and contractor against exclusion lists every month.
  • Tell us at once if you are excluded, charged with a health care crime or disciplined by your board.
  • Sign the code of conduct when hired and every year.

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 (R.S. 46:438.3)
  • 5. Compliance Oversight
  • 6. Code of Conduct
  • 7. Reporting Concerns and Non-Retaliation
  • 8. Exclusion Screening
  • 9. Auditing and Monitoring
  • 10. Investigation, Correction, and Discipline
  • 11. False Claims Laws
  • 12. Cooperation with Government Investigations
  • 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 oversees compliance, and how can staff report a concern without fear of retaliation?
  • Show me your exclusion checks for staff and contractors for the past three months.

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