The Seven Essential Elements (Chapter 2)

Question 1

What is the FIRST prescribed element of an Effective Compliance Program

Answer 1

Standards of Conduct as well as policies and procedures.

Question 2

The standards of conduct (SOC) first and foremost?

Answer 2

Demonstrate the organization’s ethical attitude and it’s enterprise-wide emphasis on compliance with all applicable laws and regulations.

Question 2

The standards of conduct provide?

Answer 2

Proper decision-making for doing the right thing.
Managers should refer to code and incorporate elements into performance reviews.
Disciplinary procedures and penalty for violation.

Question 3

Code of Conduct-Checklist

Answer 3

Reflects cultures and values of the organization.
Written plainly.
Translated into other languages as appropriate.
Mentions organizational policies without completely restating them.
Consistent with company policies and procedures.

Question 4

Code of Conduct-Employee

Answer 4

Receive, read and understand.
Training.
Attest in writing on annual basis.
Compliance enforced fairly/consistent with appropriate discipline.
Understand discipline from non-compliance.

Question 5

Code of Conduct-Purpose

Answer 5

Represent culture.
Summarize guidelines for employees
Assist employees to comprehend what is required.
Provide process for proper decision-making.
Confirm employees use standards daily
Elevate corporate performance.
Confirm organization uphold compliance conduct.

Question 6

What do policies and procedures provide?

Answer 6

Specific risk areas of risk to be addressed.

Question 7

Non-retaliation/non-retribution policy

Answer 7

Developed and communicated.
Compliance review.
One of the most important policies for compliance program effectiveness.
All employees should understand and not be afraid to bring forward issues.
Employee participation is key to the identification of issues.

Question 8

Anti-kickback Statue

Answer 8

Applies to anyone.
Prohibits any knowing and willful conduct involving the solicitation, receipt, offer or payment of any kind of remuneration in return for referring an individual.
Criminal statute.
Reimbursement from an illegal referral is a false claim.
Violation could also be offering space an no charge or less than FMV, cut-rate support for services.
Statue has safe guards through safe harbor.

Question 9

Stark Law

Answer 9

Applies to physicians referrals.
Physicians or family members who have a financial relations with an entity that provides designated health services, that physician can not make a referral for any designated health service to that entity and that entity may not bill Medicare.
Civil statute/act.
Exemptions are available.