In: Nursing
1) List three health care fraud laws and briefly explain what each does.
2) Explain what is corporate compliance and describe why it is important.
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1.HEALTH CARE FRAUD LAWS
*FALSE CLAIMS ACT (FCA)
FCA is the federal government civil statute in the case of health care fraud including combating Medicare fund. The statute prohibits a person who intentionally making false statements for payments.
Penalty :The law allow triple damages and civil punishments.
*CRIMINAL HEALTH CARE FRAUD STATUTE
A person held intentionally on use false statements to obtain funds from a federal health program or defraud any health care benefit program.
Penalty :*Upto 10 years in prison
*$500,000 or twice the amount of the fraud.
*ANTI _KICKBACK STATUTE (AKS)
It is an criminal statute which prohibits offering anything of value to induce the referral of Medicare or related business.
Penalty :*Upto 5 yrs imprisonment
*Fine of $25,000
*Suspended from medicare program for at least 5 years.
2.CORPORATE COMPLIANCE
Corporate compliance programme is formal system through which a company or organisation ensures that it is following all the laws and regulations that are related to their business. This mainly includes, the training, practices and procedures, policies and services, implementation.
IMPORTANCE OF CORPORATE COMPLIANCE
*Helps to reduce legal issues
*Improves operations and safety
*Better public relations
*Enhance higher employee retention
*High productivity in the company
*Builds positive reputation