Faculty: Donna L Atherton RN, MSN, NP and Carol Pierini MA
Successful Completion: Complete entire module, complete the exam with a passing score of 80% or better, and complete the evaluation form.
Estimated Time to Complete Activity: 60 minutes.
CEUs: HIPAA Exams is authorized by IACET to offer 0.1 CEUs for this program. CEU Information
Free Certification of Completion available instantly for download or printing upon successful completion.
This 60-minute online training will help broaden your knowledge of mandatory compliance, ethics, and prevention of fraud and abuse in healthcare. Covers federal laws including False Claim Act, Anti-Kickback Statue, Stark Law and others.
Course includes a video and audio component with stand-alone exam
Compliance, Ethics, and Fraud for Sales Professionals FAQs
In the Context of Business Ethics, What Is Fraud?
Fraud, in the context of business ethics, refers to deceitful practices or intentional misrepresentations used by individuals or entities to gain an unfair advantage, often financial.
This can involve actions like manipulating financial data, falsifying records or transactions, misappropriating assets, or engaging in deceptive practices with the intention of misleading stakeholders, customers, or regulatory bodies.
Engaging in fraud is considered unethical as it undermines trust, violates the principles of honesty and integrity, and can result in significant harm to individuals, businesses, and society at large.
How Does Creating a Culture of Honesty and Ethics Help to Reduce Fraud?
A healthy workplace environment promotes ethical practices and discourages deceitful behaviors. In such an environment, it becomes challenging for staff to justify fraudulent or corrupt actions.
A foundation of honesty, transparency, and integrity is an essential pillar of organizational resilience, mitigating fraud risks. While weak safeguards might create vulnerabilities, a poor cultural environment can be the catalyst that triggers fraud and corruption.
Moreover, ethical organizations typically invest in regular training and awareness programs to help reduce fraud. This ensures that all employees are aware of what constitutes fraud and how one can help prevent fraud.
- Identify the essentials of a well-accepted ethical principles when dealing with health care professionals.
- Compare Federal Medicare mandates.
- Expalin the components of a company compliance program.
- Reveiw programs that are in place to detect, prevent, and correct fraud, waste, and abuse.
This course is designed for sales professionals and business associates who work within the healthcare industry.
Table of Contents
Compliance, Ethics, and Fraud for Sales Professionals
Table of Contents:
- Compliance, Ethics, and Fraud
- Legal Notice
- Purpose and Learning Objectives
- Target Audience
- Compliance and Ethics in Health Care
- Mandatory Compliance
- Effective Compliance Program
- Components of an Effective Compliance Program
- Ethical Business Practices: Interactions with Health Care Professionals
- Integrity, Independence, Transparency
- Federal Health Care Fraud and Abuse Laws
- False Claim Act (FCA)
- Anti-Kickback Statue (AKS)
- Stark Law
- Exclusion Statue
- End of Course Quiz
Course Content Example 1:
Integrity, Independence, Transparency
The Department of Health and Human Services, Office of the Inspector General (OIG) mandates ethical business practices.
- Ensure the collaborative relationships with health care professionals meet high ethical standards
- Relationships must be conducted with appropriate transparency and in compliance with applicable laws, regulations and government guidance.
- Medical decisions must be based on the best interests of the patient
- Not provided inappropriate inducements to health care professionals of any monetary value, including gifts, entertainment, commissions or gratuities.
- Ensure that promotional and marketing materials on drugs or devices must be based on scientific evidence and not false information.
Course Content Example 2:
Integrity, Independence, Transparency
Prohibition of Gifts
Provide only items to Health Care Professionals (HCPs) that benefit patients or serve a genuine educational function for HCP.
- Other than medical textbooks or anatomical models, any item should have a fair market value of less than $100.00
Non-Educational branded promotional items may not be given, even if minimal value.
- No cookies, wine, flowers, chocolates, gift baskets, holiday gifts, cash or cash equivalent may be given
Course Content Example 3:
Components of an Effective Compliance Program
- Commitment by the organization's senor leadership for an effective compliance and ethics program.
- Policies and Procedures. Written standards and procedures to reduce criminal, civil, and administrative violations.
- Should be tailored to fit specific risk assessment conducted by your organization to identify risk areas faced in the healthcare arena.
- Chief Compliance Officer. A high-ranking individual in the organization should be designated responsible for the compliance program.
- The officer should possess resources and authority to implement the program and should report to the senior leadership of the company.
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