2017 CMS General Compliance Training 1. Medicare Parts C and D General Compliance Training

Transcription

1 2017 CMS General Compliance Training 1. Medicare Parts C and D General Compliance Training

2 1.3 Introduction

3 1.4 Introduction

4 1.5 Introduction

5 1.6 Why Do I Need Training?

6 1.7 Training Requirements

7 1.8 Learn More

8 1.9 Course Content

9 1.10 Course Objectives

10 1.11 Introduction and Learning Objectives

11 1.12 Compliance Program Requirement

12 1.13 What is an Effective Compliance Program?

13 1.14 What is an Effective Compliance Program? (continued)

14 1.15 Seven Core Compliance Program Requirements

15 1.16 Seven Core Compliance Program Requirements (continued)

16 1.17 Seven Core Compliance Program Requirements (continued)

17 1.18 Compliance Training - Sponsors and their FDRs

18 1.19 Ethics - Do the Right Thing!

19 1.20 How Do You Know What Is Expected of You?

20 1.21 What is Non-Compliance?

21 1.22 What is Non-Compliance? (continued)

22 1.23 Know the Consequences

23 1.24 Non-Compliance Affects Everybody

24 1.25 How to Report Potential Non-Compliance

25 1.26 How to Report Potential Non-Compliance (continued)

26 1.27 What Happens After Non-Compliance is Detected?

27 1.28 What Are Internal Monitoring and Audits?

28 1.29 Lesson Summary

29 1.30 Compliance Is Everyone's Responsibility

30 1.31 Lesson Review

31 1.32 Knowledge Check

32 1.33 Knowledge Check Answer

33 1.34 Knowledge Check

34 1.35 Knowledge Check Answer

35 1.36 Knowledge Check

36 1.37 Knowledge Check Answer

37 1.38 Knowledge Check

38 1.39 Knowledge Check Answer

39 1.40 You've completed the lesson!

40 1.41 Post-Assessment

41 1.42 Question 1 of 10 Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper Management only. Correct Choice True False 1.43 Question 2 of 10 Ways to report a compliance issue include: Correct Choice Telephone hotlines Report on the Sponsor s website In-person reporting to the compliance department/supervisor All of the above

42 1.44 Question 3 of 10 What is the policy of non-retaliation? Correct Choice Allows the Sponsor to discipline employees who violate the Code of Conduct Prohibits management and supervisor from harassing employees for misconduct Protects employees who, in good faith, report suspected non-compliance Prevents fights between employees 1.45 Question 4 of 10 These are examples of issues that can be reported to a Compliance Department: suspected Fraud, Waste and Abuse (FWA); potential health privacy violation, and unethical behavior/employee misconduct. Correct Choice True False

43 1.46 Question 5 of 10 Once a corrective action plan begins addressing non-compliance or Fraud, Waste, and Abuse (FWA) committed by a Sponsor s employee or First-Tier, Downstream, or Related Entity s (FDR s) employee, ongoing monitoring of the corrective actions is not necessary. Correct Choice True False 1.47 Question 6 of 10 Medicare Parts C and D plan Sponsors are not required to have a compliance program. Correct Choice True False 1.48 Question 7 of 10 At a minimum, an effective compliance program includes four core requirements. Correct Choice True False

44 1.49 Question 8 of 10 Standards of Conduct are the same for every Medicare Parts C and D Sponsor. Correct Choice True False 1.50 Question 9 of 10 Correcting non-compliance. Correct Choice Protects enrollees, avoids recurrence of the same non-compliance, and promotes efficiency Ensures bonuses for all employees Both A. and B Question 10 of 10 What are some of the consequences for non-compliance, fraudulent, or unethical behavior? Correct Choice Disciplinary action Termination of employment Exclusion from participation in all Federal health care programs All of the above

45 2017 CMS General Compliance Training Answer Key 1.42 Question 1 of 10 Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper Management only. Correct Choice True X False 1.43 Question 2 of 10 Ways to report a compliance issue include: Correct Choice Telephone hotlines Report on the Sponsor s website In-person reporting to the compliance department/supervisor X All of the above

46 1.44 Question 3 of 10 What is the policy of non-retaliation? Correct Choice Allows the Sponsor to discipline employees who violate the Code of Conduct Prohibits management and supervisor from harassing employees for misconduct X Protects employees who, in good faith, report suspected non-compliance Prevents fights between employees 1.45 Question 4 of 10 These are examples of issues that can be reported to a Compliance Department: suspected Fraud, Waste and Abuse (FWA); potential health privacy violation, and unethical behavior/employee misconduct. Correct X Choice True False

47 1.46 Question 5 of 10 Once a corrective action plan begins addressing non-compliance or Fraud, Waste, and Abuse (FWA) committed by a Sponsor s employee or First-Tier, Downstream, or Related Entity s (FDR s) employee, ongoing monitoring of the corrective actions is not necessary. Correct Choice True X False 1.47 Question 6 of 10 Medicare Parts C and D plan Sponsors are not required to have a compliance program. Correct Choice True X False 1.48 Question 7 of 10 At a minimum, an effective compliance program includes four core requirements. Correct Choice True X False

48 1.49 Question 8 of 10 Standards of Conduct are the same for every Medicare Parts C and D Sponsor. Correct Choice True X False 1.50 Question 9 of 10 Correcting non-compliance. Correct X Choice Protects enrollees, avoids recurrence of the same non-compliance, and promotes efficiency Ensures bonuses for all employees Both A. and B Question 10 of 10 What are some of the consequences for non-compliance, fraudulent, or unethical behavior? Correct Choice Disciplinary action Termination of employment Exclusion from participation in all Federal health care programs X All of the above