DCAA Audits of Compliance Systems and the Implications of Changes in the False Claims Act for Universities

Size: px
Start display at page:

Download "DCAA Audits of Compliance Systems and the Implications of Changes in the False Claims Act for Universities"

Transcription

1 DCAA Audits of Compliance Systems and the Implications of Changes in the False Claims Act for Universities SCCE s Higher Education Compliance Conference Kwamina Thomas Williford Partner, Holland & Knight LLP June 14, 2011 Copyright 2010 Holland & Knight LLP All Rights Reserved

2 Presentation Overview 1. Background: Existing High Risk Regulatory Environment 2. Defense Contractor Audit Agency s (DCAA) Get Tough Audit Guidance 3. False Claims Act Considerations 4. Implications for Universities Contracting with the Government 5. Practical Take Aways 2

3 Background: Existing High Risk Regulatory Environment 3

4 Background: New Considerations and Higher Risk Environment For Universities Contracting with the Government Existing high risk environment for Universities contracting with the government DCAA - Government s primary audit agency increases scrutiny of compliance systems Expanded False Claims Act includes new perils for Universities New considerations to navigate to avoid scrutiny 4

5 Background: Mandatory Compliance Program Universities that have contracts in excess of $5 million with a performance period of more than 120 days must have an ongoing compliance program that: has a written code of business ethics and conduct; makes a copy of the code available to all working on the contract; emphasizes due diligence to prevent and detect improper conduct; and promotes an organizational culture of compliance. FAR (b). 5

6 Background: Mandatory Disclosure of Violations Such contractors must disclose credible evidence that a principal, employee or agent violated: a federal criminal law involving fraud, conflicts of interest, bribery or improper gratuity under Title 18 of the U.S. Code; or the Civil False Claims Act in connection with a federal government contract. FAR (b)(3). 6

7 Background: Required Internal Controls Such contractors are required to have an Internal Control System in place, which includes: High level assignment of responsibility for controls & adequate resources to ensure effectiveness Reasonable efforts not to include as principals people who engaged in conduct contrary to the code of business ethics & conduct Auditing and monitoring of procedures Internal reporting mechanisms (i.e. hotlines) Timely disclosure of improper conduct related to any government contract Disciplinary action for improper conduct Risk assessments and evaluations of effectiveness of program and controls FAR (c)(2). 7

8 Background: Full Cooperation Such contractors are required to fully cooperate with government audits and investigations. To fully cooperate means the: [D]isclosure to the Government of the information sufficient to identify the nature and extent of the offense and the individuals responsible for the conduct [T]imely and complete response to Government auditors and investigators request for documents and access to employees with information FAR (c)(2)(ii)(G). 8

9 DCAA s New Get Tough Audit Guidance 9

10 DCAA s Get Tough Audit Guidance: The Basics DCAA is the government s primary audit agency extends beyond contracts with the Department of Defense Most Universities who have contracts with the Government are subject to DCAA s Audit 10

11 DCAA s Get Tough Audit Guidance: Theory Contractors business systems and internal controls are a key line of defense against waste, fraud, and abuse Strong effective control systems decrease the risk of unallowable and unreasonable costs on government contracts 11

12 DCAA s Get Tough Audit Guidance: Evolution All internal control deficiencies that result in or could result in unallowable costs should be reported as significant deficiencies and considered material weaknesses Inadequate in part allowed if deficiencies affect only certain control objectives permits auditor judgment Suggestions to improve the system allowed if condition found does not materially impact contract costs, but the system is enhanced if needed. MRD Number 08-PAS-011(R), DCAA Audit Guidance on Reporting Internal Control Deficiencies, dated March 3,

13 DCAA s Get Tough Audit Guidance: Evolution DCAA challenged by U.S. Government Accountability Office (GAO) alleged failure to comply with government auditing standards Congressional demands for DCAA audit improvement Seeks dramatic changes in audit protocols, demands for information and audit results DCAA s new audit guidance emphasizes thorough implementation of compliance and ethics programs. 13

14 DCAA s Get Tough Audit Guidance: Current State DCAA audit reports are effectively pass/fail. Any significant deficiencies/material weaknesses will result in opinion that system is inadequate. DCAA no longer has inadequate in part as an option. DCAA will no longer offer suggestions on how to improve the system in an internal control audit report. If timely documentation not provided, auditor will follow procedures for denial of access to records, take action to suspend costs from billings and question costs. MRD Number 08-PAS-043(R), DCAA Audit Guidance on Significant Deficiencies/Material Weaknesses and Audit Opinions on Internal Control Systems, dated December 19,

15 DCAA s Formal Information Request DCAA created a formal request for information regarding a contractor s internal compliance system controls. Based on such information, DCAA will likely evaluate: Contractor s policies, procedures, training, and compliance with policies and procedures related to conveying integrity and ethical values; The contractor s self-governance and the making of adequate disclosures to the government; 15

16 DCAA s Formal Information Request DCAA will likely evaluate: (cont.) The intervention of contractor s management and any overrides (including assessing compliance with the contractor s policies and procedures); Internal and external audit functions and efforts related to the contractor s accounting system; and The most recent annual report and its internal control report (which should assess the internal control structure for financial reporting). 16

17 DCAA s Formal Information Request DCAA s formal requests for information are document intensive DCAA expects: These documents to be readily available That the contractor will provide access to personnel, including the person responsible for the information MRD Number 08-PAS-042(R), DCAA Audit Guidance on Denial of Access to Records Due to Contractor Delays, dated December 19,

18 False Claims Act: Additional Considerations 18

19 False Claims Act The civil False Claims Act imposes civil liability on a person if they knowingly: submit, or cause the submission of, a false or fraudulent claim for payment to the government; make, use, or cause to be made or used (through conspiracy or otherwise), a false record or statement material to a false or fraudulent claim for payment made to the government; or make a false record or statement to conceal or avoid an obligation for payment to the government. 29 U.S.C. 3729, et. seq. 19

20 False Claims Act Considerations Amendments to the False Claims Act increase exposure: Creates the reverse false claim by creating liability for the retention of an overpayment or other obligation to pay or transmit money or property to the government Expands reach to subcontractors Expands anti-retaliation provision to prevent retaliation for claims brought by contractors and agents as well as employees Allows liability to attach as long as claim is material, no longer is a specific intent to submit the false claim necessary Fraud Enforcement And Recovery Act of 2009, Pub. L , 123 Stat 1617 (May 2009) 20

21 Implications For Universities Contracting with the Government 21

22 Implications: Tougher Compliance Standards Compliance programs will receive substantial attention from DCAA. Discretion taken away from auditor regarding what it means to have a reportable significant deficiency/material weakness. Failure to properly implement elements of the required compliance program and related controls may be enough to constitute a reportable significant deficiency/material weakness. Control systems found adequate in past are now being found inadequate. 22

23 Implications: Monetary Consequences Internal Control systems found to be inadequate may result in: Disallowance of unsupported costs Suspension of percentage of progress payments MRD Number 08-PAS-043(R), DCAA Audit Guidance on Significant Deficiencies/Material Weaknesses and Audit Opinions on Internal Control Systems, dated December 19, 2008; DFARS Case 2009-D038, Business Systems Definition and Administration, Interim rule, 76 Fed. Reg , May 18,

24 Implications: Access to Information Considerations Understand your obligations regarding requests for information. DCAA right of access to contractor personnel should be managed. Full cooperation requirement -- does not require waiver of attorney-client privilege; does not require waiver of 5 th amendment privilege; and does not foreclose contractor internal investigation, or defense of any proceeding brought by the government 24

25 Implications: Access to Information Considerations (cont.) DCAA s formal request for information claims to be based on a contractor s purported requirement to report any suspected violation of law to government officials. The FAR does not require disclosure unless a Principal of the contractor has credible evidence that a violation has been committed. See e.g., FAR (b). 25

26 Implications: Access to Information Considerations (cont.) Government guidance on the mandatory disclosure requirement says contractors will have sufficient opportunity to investigate whether or not credible evidence of a reportable violation exists. Due to recent challenges to in-house attorney-client privilege, great care should be taken to document when inhouse lawyers are acting in purely legal functions Consider conducting serious compliance investigations through outside counsel 26

27 Implications: False Claims Act Considerations Already increased enforcement of False Claims Act, including enforcement against Universities Increased oversight and scrutiny by DCAA of Universities internal controls records request specifically looks at self governance controls DCAA may refer problems to Inspector General as a basis for False Claims Act action Mandatory reporting requirements now apply to retention of overpayments Mandatory reporting requires disclosure of facts that are material to a claim for payment 27

28 Practical Take Aways in light of New Environment 28

29 Practical Take-Aways Proactive engagement with DCAA chain of command understand intended audit plan, clarify protocol Enhance internal communications regarding audit activities Raise visibility of compliance department within University Perform internal/external compliance assessments 29

30 Practical Take-Aways (Cont.) Perform fraud risk assessments for special requirements of government relationships (Consider confidentiality and attorney-client privilege) Integrate and align key departments (Compliance, Internal Audit, Controller) to coordinate focus on controls and risks Anticipate DCAA requests for information Prompt response investigation, resolution, corrective action, disclosure of reported violations 30

31 Questions Kwamina Thomas Williford Holland & Knight LLP 2099 Pennsylvania, Ave., NW Washington, D.C., Phone:

Federal Government Ethics Compliance Training. Federal Acquisition Regulation

Federal Government Ethics Compliance Training. Federal Acquisition Regulation Federal Government Ethics Compliance Training Federal Acquisition Regulation Presentation Overview Historical overview of Federal Acquisition Regulation Compliance and requirements Code of Ethics Ethical

More information

Master Document Audit Program. Version 1.8, dated November 2015. B-01 Planning Considerations

Master Document Audit Program. Version 1.8, dated November 2015. B-01 Planning Considerations Activity Code 11060 Control Environment Version 1.8, dated November 2015 B-01 Planning Considerations Audit Specific Independence Determination Members of the audit team and internal specialists consulting

More information

November - December 2011 CONSTRUCTION FINANCIAL MANAGEMENT ASSOCIATION. The Source & Resource for Construction Financial Professionals

November - December 2011 CONSTRUCTION FINANCIAL MANAGEMENT ASSOCIATION. The Source & Resource for Construction Financial Professionals R E P R I N T November - December 2011 CONSTRUCTION FINANCIAL MANAGEMENT ASSOCIATION The Source & Resource for Construction Financial Professionals BY DIRK D. HAIRE & FARAH A. SHAH FAR Ethics & Compliance

More information

GAO DEFENSE CONTRACTING INTEGRITY. Opportunities Exist to Improve DOD s Oversight of Contractor Ethics Programs. Report to Congressional Committees

GAO DEFENSE CONTRACTING INTEGRITY. Opportunities Exist to Improve DOD s Oversight of Contractor Ethics Programs. Report to Congressional Committees GAO United States Government Accountability Office Report to Congressional Committees September 2009 DEFENSE CONTRACTING INTEGRITY Opportunities Exist to Improve DOD s Oversight of Contractor Ethics Programs

More information

PHI Air Medical, L.L.C. Compliance Plan

PHI Air Medical, L.L.C. Compliance Plan Page No. 1 of 13 Introduction: The PHI Air Medical, L.L.C. is to be used by employees, contractors and vendors to get a high level understanding of the key regulatory requirements relating to our participation

More information

IMAX CORPORATION PROTOCOL FOR REPORTING SUSPECTED VIOLATIONS OF THE IMAX CODE OF ETHICS. (Whistle Blower Program)

IMAX CORPORATION PROTOCOL FOR REPORTING SUSPECTED VIOLATIONS OF THE IMAX CODE OF ETHICS. (Whistle Blower Program) IMAX CORPORATION PROTOCOL FOR REPORTING SUSPECTED VIOLATIONS OF THE IMAX CODE OF ETHICS (Whistle Blower Program) November 2004 (updated February 2012) PROTOCOL FOR REPORTING SUSPECTED VIOLATIONS OF THE

More information

Peckar & Abramson. A Professional Corporation Attorneys & Counselors at Law

Peckar & Abramson. A Professional Corporation Attorneys & Counselors at Law A Professional Corporation Attorneys & Counselors at Law EXPANSION OF FEDERAL GOVERNMENT AUDIT POWERS AND PROGRAMS: WHAT TO DO WHEN THE AUDITORS ARRIVE Our earlier s described initiatives by the federal

More information

Establishing An Effective Corporate Compliance Program Joan Feldman, Esq. Vincenzo Carannante, Esq. William Roberts, Esq.

Establishing An Effective Corporate Compliance Program Joan Feldman, Esq. Vincenzo Carannante, Esq. William Roberts, Esq. Establishing An Effective Corporate Compliance Program Joan Feldman, Esq. Vincenzo Carannante, Esq. William Roberts, Esq. November 11, 2014 Shipman & Goodwin LLP 2014. All rights reserved. HARTFORD STAMFORD

More information

Title: False Claims Act & Whistleblower Protection Information and Education

Title: False Claims Act & Whistleblower Protection Information and Education Care Initiatives Policy and Procedure Title: False Claims Act & Whistleblower Protection Information and Education Version Number Implemented By Revision Date Approved By Approval Date Initial Compliance

More information

Mental Health Resources, Inc. Mental Health Resources, Inc. Corporate Compliance Plan Corporate Compliance Plan

Mental Health Resources, Inc. Mental Health Resources, Inc. Corporate Compliance Plan Corporate Compliance Plan Mental Health Resources, Inc. Mental Health Resources, Inc. Corporate Compliance Plan Corporate Compliance Plan Adopted: January 2, 2007 Revised by Board of Directors on September 4, 2007 Revised and Amended

More information

USC Office of Compliance

USC Office of Compliance PURPOSE This policy complies with requirements under the Deficit Reduction Act of 2005 and other federal and state fraud and abuse laws. It provides guidance on activities that could result in incidents

More information

PROPOSED AMENDMENT TO REVISED PROPOSED FAR RULE TITLED CONTRACTOR COMPLIANCE PROGRAM AND INTEGRITY REPORTING, FAR CASE 2007-006, 72 FED. REG. 64019 AND 73 FED. REG. 28407 PREPARED BY THE AMERICAN BAR ASSOCIATION

More information

AN ACT IN THE COUNCIL OF THE DISTRICT OF COLUMBIA

AN ACT IN THE COUNCIL OF THE DISTRICT OF COLUMBIA AN ACT IN THE COUNCIL OF THE DISTRICT OF COLUMBIA To amend the District of Columbia Procurement Practices Act of 1985 to make the District s false claims act consistent with federal law and thereby qualify

More information

Understanding Health Reform s

Understanding Health Reform s Compliance 101: Understanding Health Reform s New Compliance Requirements Uri Bilek Feldesman Tucker Leifer Fidell LLP Does your organization have a designated Compliance Officer? a. Yes b. No c. Don't

More information

Accountable Care Organization. Medicare Shared Savings Program. Compliance Plan

Accountable Care Organization. Medicare Shared Savings Program. Compliance Plan Accountable Care Organization Participating In The Medicare Shared Savings Program Compliance Plan 2014 Corporate Location: 3190 Fairview Park Drive Falls Church, VA 22042 ARTICLE I INTRODUCTION This Compliance

More information

C O N F I D E N T I A L A N D P R O P R I E T A R Y. Page 1 of 7 Title: FRAUD, WASTE, AND ABUSE POLICY

C O N F I D E N T I A L A N D P R O P R I E T A R Y. Page 1 of 7 Title: FRAUD, WASTE, AND ABUSE POLICY Page 1 of 7 1. Purpose As a Company that does business with U.S. state and federal government health care programs (such as Medicare and Medicaid), Hill-Rom is required to maintain a system of policies

More information

U.S. Department of Justice Office of the Inspector General. Improving the Grant Management Process

U.S. Department of Justice Office of the Inspector General. Improving the Grant Management Process U.S. Department of Justice Office of the Inspector General Improving the Grant Management Process February 2009 u.s. Department of Justice Office of the Inspector General Improving the Grant Management

More information

VILLAGECARE CORPORATE COMPLIANCE POLICY AND PROCEDURE MANUAL ORIGINAL EFFECTIVE DATE: JANUARY 1, 2007

VILLAGECARE CORPORATE COMPLIANCE POLICY AND PROCEDURE MANUAL ORIGINAL EFFECTIVE DATE: JANUARY 1, 2007 VILLAGECARE CORPORATE COMPLIANCE POLICY AND PROCEDURE MANUAL SUBJECT: COMPLIANCE WITH FEDERAL AND STATE FALSE CLAIMS LAWS AND DETECTION AND PREVENTION OF FRAUD, WASTE AND ABUSE LAST POLICY REVISION EFFECTIVE

More information

Hotline Complaint Regarding the Defense Contract Audit Agency Examination of a Contractor s Subcontract Costs

Hotline Complaint Regarding the Defense Contract Audit Agency Examination of a Contractor s Subcontract Costs Inspector General U.S. Department of Defense Report No. DODIG-2015-061 DECEMBER 23, 2014 Hotline Complaint Regarding the Defense Contract Audit Agency Examination of a Contractor s Subcontract Costs INTEGRITY

More information

Metropolitan Jewish Health System and its Participating Agencies and Programs [MJHS]

Metropolitan Jewish Health System and its Participating Agencies and Programs [MJHS] Metropolitan Jewish Health System and its Participating Agencies and Programs [MJHS] POLICY PURSUANT TO THE FEDERAL DEFICIT REDUCTION ACT OF 2005: Detection and Prevention of Fraud, Waste, and Abuse and

More information

I. Introduction. 1919 Madison Avenue, New York, NY 10035 tel: 212-987-1777 toll free: 866-778-6827 fax: 212-987-1776

I. Introduction. 1919 Madison Avenue, New York, NY 10035 tel: 212-987-1777 toll free: 866-778-6827 fax: 212-987-1776 I. Introduction The Ralph Lauren Center for Cancer Care ( RLCCC or The Center ) operates a freestanding diagnostic and treatment center, licensed under Article 28 of the New York State health law, located

More information

False Claims Act NUMBER NH-LD-CP-220 Last Revised/Reviewed TITLE. Apr13. LD, CP Corporate Wide TJC FUNCTIONS APPLIES TO I.

False Claims Act NUMBER NH-LD-CP-220 Last Revised/Reviewed TITLE. Apr13. LD, CP Corporate Wide TJC FUNCTIONS APPLIES TO I. ADMINISTRATIVE TITLE False Claims Act NUMBER NH-LD-CP-220 Last Revised/Reviewed Effective Date: TJC FUNCTIONS APPLIES TO LD, CP Corporate Wide Apr13 I. SCOPE / PURPOSE It is the policy of Novant Health

More information

CENTER FOR INSTRUCTION TECHNOLOGY AND INNOVATION (CiTi) MEDICAID BILLING COMPLIANCE PROGRAM

CENTER FOR INSTRUCTION TECHNOLOGY AND INNOVATION (CiTi) MEDICAID BILLING COMPLIANCE PROGRAM CENTER FOR INSTRUCTION TECHNOLOGY AND INNOVATION (CiTi) MEDICAID BILLING COMPLIANCE PROGRAM INTRODUCTION This Program is an integral part of the CiTi s ongoing efforts to achieve compliance with federal

More information

The United States spends more than $1 trillion each year on healthcare

The United States spends more than $1 trillion each year on healthcare Managed Care Fraud and Abuse Compliance Guidelines I. Introduction The United States spends more than $1 trillion each year on healthcare representing approximately 15 percent of the gross national product.

More information

Standards of. Conduct. Important Phone Number for Reporting Violations

Standards of. Conduct. Important Phone Number for Reporting Violations Standards of Conduct It is the policy of Security Health Plan that all its business be conducted honestly, ethically, and with integrity. Security Health Plan s relationships with members, hospitals, clinics,

More information

Minimizing Your Risks Under the Dodd-Frank Whistleblower Provisions

Minimizing Your Risks Under the Dodd-Frank Whistleblower Provisions Minimizing Your Risks Under the Dodd-Frank Whistleblower Provisions Rosemary Alito Carol Elder Bruce Matt T. Morley November 11, 2010 Copyright 2010 by K&L Gates LLP. All rights reserved. Dodd-Frank Whistleblower

More information

Compliance with False Claims Act

Compliance with False Claims Act MH Policy and Procedure Document Number: MH-COMPLY-001 Document Owner: Corporate Compliance Officer Date Last Author: Corporate Compliance Officer General Description Purpose: To establish written guidelines

More information

The Fraud Enforcement and Recovery Act and Healthcare Reform: Implications for Compliance Initiatives and Fraud Investigations

The Fraud Enforcement and Recovery Act and Healthcare Reform: Implications for Compliance Initiatives and Fraud Investigations The Fraud Enforcement and Recovery Act and Healthcare Reform: Implications for Compliance Initiatives and Fraud Investigations Presented by: Robert Threlkeld, Esq. Holly Pierson, Esq. Paul F. Danello,

More information

Fraud, Waste and Abuse Prevention and Education Policy

Fraud, Waste and Abuse Prevention and Education Policy Corporate Compliance Fraud, Waste and Abuse Prevention and Education Policy The Compliance Program at the Cortland Regional Medical Center (CRMC) demonstrates our commitment to uphold all federal and state

More information

This policy applies to UNTHSC employees, volunteers, contractors and agents.

This policy applies to UNTHSC employees, volunteers, contractors and agents. Policies of the University of North Texas Health Science Center 3.102 Detecting and Responding to Fraud, Waste and Abuse Chapter 3 Compliance Policy Statement UNTHSC developed and implemented a Compliance

More information

Reports of Compliance Concerns and Violations

Reports of Compliance Concerns and Violations The University of Chicago Medical Center Compliance Manual (UCHHS;BSD;UCPP) Reports of Compliance Concerns and Violations Issued: November 1, 1999 Reports of Compliance Concerns and Violations Revised:

More information

Amendments To The False Claims Act. July 7, 2009

Amendments To The False Claims Act. July 7, 2009 1 Amendments To The False Claims Act July 7, 2009 2 About this Webcast Need both browser & Webex open Rejoin webcast: Follow link in email Event number: 688 252 507 Event password: Cfca2009 Rejoin call:

More information

VNSNY CORPORATE. DRA Policy

VNSNY CORPORATE. DRA Policy VNSNY CORPORATE DRA Policy TITLE: FEDERAL DEFICIT REDUCTION ACT OF 2005: POLICY REGARDING THE DETECTION & PREVENTION OF FRAUD, WASTE AND ABUSE AND APPLICABLE FEDERAL AND STATE LAWS APPLIES TO: VNSNY ENTITIES

More information

The Devil is in the Details Compliance with the Business Systems Rule

The Devil is in the Details Compliance with the Business Systems Rule Metropolitan Area Corporate Counsel Association WMACCA Conference on Ethics and Compliance for Government Contractors The Devil is in the Details Compliance with the Business Systems Rule April 1, 2014

More information

PITTSBURGH CARE PARTNERSHIP, INC. COMMUNITY LIFE PROGRAM POLICY AND PROCEDURE MANUAL. False Claims Act Explanation and Reporting Requirements

PITTSBURGH CARE PARTNERSHIP, INC. COMMUNITY LIFE PROGRAM POLICY AND PROCEDURE MANUAL. False Claims Act Explanation and Reporting Requirements SUBJECT: False Claims Act Explanation and Reporting Requirements NUMBER: 1004 CROSS REFERENCE NUMBER: 1823 REG. REF.: 31 U.S.C. 37-29 PURPOSE: POLICY: The purposes of this policy are to describe the Federal

More information

COMPLIANCE PROGRAM GUIDANCE FOR MEDICARE FEE-FOR-SERVICE CONTRACTORS

COMPLIANCE PROGRAM GUIDANCE FOR MEDICARE FEE-FOR-SERVICE CONTRACTORS Department of Health and Human Services CENTERS FOR MEDICARE & MEDICAID SERVICES COMPLIANCE PROGRAM GUIDANCE FOR MEDICARE FEE-FOR-SERVICE CONTRACTORS March 2005 TABLE OF CONTENTS INTRODUCTION...3 ELEMENTS

More information

Introductions. Today s Topics 10/12/2015

Introductions. Today s Topics 10/12/2015 Healthcare Enforcement Compliance Institute Tuesday, October 7, 2015 Laubach/Waltz HCCA October 2015 1 Introductions Judy Waltz Lori Laubach 2 Today s Topics Identifying the need for auditing (and refunds)

More information

TREASURY INSPECTOR GENERAL FOR TAX ADMINISTRATION

TREASURY INSPECTOR GENERAL FOR TAX ADMINISTRATION TREASURY INSPECTOR GENERAL FOR TAX ADMINISTRATION The Internal Revenue Service September 14, 2010 Reference Number: 2010-10-115 This report has cleared the Treasury Inspector General for Tax Administration

More information

NewYork-Presbyterian Hospital Sites: All Centers Hospital Policy and Procedure Manual Number: D160 Page 1 of 9

NewYork-Presbyterian Hospital Sites: All Centers Hospital Policy and Procedure Manual Number: D160 Page 1 of 9 Page 1 of 9 TITLE: FEDERAL DEFICIT REDUCTION ACT OF 2005 FRAUD AND ABUSE PROVISIONS POLICY: NewYork- Presbyterian Hospital (NYP or the Hospital) is committed to preventing and detecting any fraud, waste,

More information

POLICY AND PROCEDURES MANUAL FRAUD, WASTE, AND ABUSE

POLICY AND PROCEDURES MANUAL FRAUD, WASTE, AND ABUSE Page Number: 1 of 7 TITLE: PURPOSE: FRAUD, WASTE, AND ABUSE The Harris County Hospital District implemented a Corporate Compliance Program in an effort to establish effective internal controls that promote

More information

POUGHKEEPSIE CITY SCHOOL DISTRICT PUPIL PERSONNEL DEPARTMENT S MEDICAID BILLING COMPLIANCE PROGRAM AND PROCEDURES

POUGHKEEPSIE CITY SCHOOL DISTRICT PUPIL PERSONNEL DEPARTMENT S MEDICAID BILLING COMPLIANCE PROGRAM AND PROCEDURES POUGHKEEPSIE CITY SCHOOL DISTRICT PUPIL PERSONNEL DEPARTMENT S MEDICAID BILLING COMPLIANCE PROGRAM AND PROCEDURES INTRODUCTION This Poughkeepsie City School District Medicaid Billing Compliance Program

More information

a. employees Company; or

a. employees Company; or Code of Busines ss Conduct and Ethics 1. Introduction a. This Code of Business Conduct and Ethics (the Code ) applies to all directors, officers, employees and third parties employed or directly engaged

More information

Focus. FEATURE COMMENT: DCAA Access To Information What You Need To Know And Strategies For Protecting Your Business

Focus. FEATURE COMMENT: DCAA Access To Information What You Need To Know And Strategies For Protecting Your Business Reprinted from The Government Contractor, with permission of Thomson Reuters. Copyright 2014. Further use without the permission of West is prohibited. For further information about this publication, please

More information

Client Alert October 3, 2011. Questions Page and a link to the SEC Final Rules addressing the Whistleblower Program.

Client Alert October 3, 2011. Questions Page and a link to the SEC Final Rules addressing the Whistleblower Program. THE SEC OFFICE OF THE WHISTLEBLOWER OPENS FOR BUSINESS New SEC Rules Provide Substantial Incentives and Protections to Encourage Individuals to Report Possible Violations of the Federal Securities Laws

More information

Corporate Compliance and Ethics

Corporate Compliance and Ethics Corporate Compliance and Ethics Title: Corporate Compliance and Ethics Course Code: EL-CCE-COMP-0 Course Outline Section 1: Introduction A. Course Contributors B. About This Course C. Learning Objectives

More information

c) Provider Identification Number(s) associated with claims,

c) Provider Identification Number(s) associated with claims, Title 23: Division of Medicaid Part 305: Program Integrity Part 305 Chapter 1: Program Integrity Rule 1.1: Fraud and Abuse A. Title XIX of the Social Security Act, the implementing federal regulations

More information

SOUTH NASSAU COMMUNITIES HOSPITAL One Healthy Way, Oceanside, NY 11572

SOUTH NASSAU COMMUNITIES HOSPITAL One Healthy Way, Oceanside, NY 11572 SOUTH NASSAU COMMUNITIES HOSPITAL One Healthy Way, Oceanside, NY 11572 POLICY TITLE: Compliance with Applicable Federal and State False Claims Acts POLICY NUMBER: OF-ADM-232 DEPARTMENT: Hospital-wide CROSS-REFERENCE:

More information

CORPORATE COMPLIANCE: BILLING & CODING COMPLIANCE

CORPORATE COMPLIANCE: BILLING & CODING COMPLIANCE SUBJECT: CORPORATE COMPLIANCE: BILLING & CODING COMPLIANCE MISSION: Quality, honesty and integrity, in everything we do, are important values to all of us who are associated with ENTITY NAME ( ENTITY NAME

More information

The Federal Acquisition Regulation Mandatory Disclosure Rule Program at the U.S. General Services Administration Office of Inspector General

The Federal Acquisition Regulation Mandatory Disclosure Rule Program at the U.S. General Services Administration Office of Inspector General The Federal Acquisition Regulation Mandatory Disclosure Rule Program at the U.S. General Services Administration Office of Inspector General By Brian D. Miller, Inspector General of the U.S. General Services

More information

SCAN Health Plan Policy and Procedure Number: CRP-0067, False Claims Act & Deficit Reduction Act 2005

SCAN Health Plan Policy and Procedure Number: CRP-0067, False Claims Act & Deficit Reduction Act 2005 Health Plan Policy and Procedure Number: CRP-0067, False Claims Act & Deficit Reduction Act 2005 Approver Approval Stage Date Chris Zorn Approval Event (Authoring) 12/09/2013 Nancy Monk Approval Event

More information

BAPTIST HEALTH CORPORATE COMPLIANCE PLAN

BAPTIST HEALTH CORPORATE COMPLIANCE PLAN BAPTIST HEALTH CORPORATE COMPLIANCE PLAN BAPTIST HEALTH and its subsidiaries have a long-standing reputation for conducting both business and patient care activities with the highest level of ethical behavior

More information

TEMPLE UNIVERSITY HEALTH SYSTEM CORPORATE COMPLIANCE PROGRAM TABLE OF CONTENTS PAGE A LETTER FROM THE CHAIR OF THE BOARD...2

TEMPLE UNIVERSITY HEALTH SYSTEM CORPORATE COMPLIANCE PROGRAM TABLE OF CONTENTS PAGE A LETTER FROM THE CHAIR OF THE BOARD...2 TEMPLE UNIVERSITY HEALTH SYSTEM CORPORATE COMPLIANCE PROGRAM TABLE OF CONTENTS PAGE A LETTER FROM THE CHAIR OF THE BOARD...2 TEMPLE UNIVERSITY HEALTH SYSTEM, INC.: MISSION VISION AND VALUES...3 A. THE

More information

Fraud, Waste and Abuse

Fraud, Waste and Abuse Fraud, Waste and Abuse Policy Statement: Justification: Departments Involved: All LOBs Involved: All Colorado Access is dedicated to providing quality healthcare services to members while conducting business

More information

MEDICAID COMPLIANCE POLICY

MEDICAID COMPLIANCE POLICY 6232 MEDICAID COMPLIANCE POLICY It is the policy of the Board of Education that all school district s practices regarding Medicaid claims for services be in compliance with all applicable federal and state

More information

Compliance Training for Medicare Programs Version 1.0 2/22/2013

Compliance Training for Medicare Programs Version 1.0 2/22/2013 Compliance Training for Medicare Programs Version 1.0 2/22/2013 Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association. 1 The Compliance Program Setting standards

More information

Title: Preventing and Reporting Fraud, Waste and Abuse in Federal Health Care Programs. Area Manual: Corporate Compliance Page: Page 1 of 10

Title: Preventing and Reporting Fraud, Waste and Abuse in Federal Health Care Programs. Area Manual: Corporate Compliance Page: Page 1 of 10 Title: Preventing and Reporting Fraud, Waste and Abuse in Federal Health Care Programs Area Manual: Corporate Compliance Page: Page 1 of 10 Reference Number: I-70 Effective Date: 10/02 Contact Person:

More information

METHODIST HEALTH SYSTEM ADMINISTRATIVE TITLE: DETECTING FRAUD AND ABUSE AND AN OVERVIEW OF THE FEDERAL AND STATE FALSE CLAIMS ACTS

METHODIST HEALTH SYSTEM ADMINISTRATIVE TITLE: DETECTING FRAUD AND ABUSE AND AN OVERVIEW OF THE FEDERAL AND STATE FALSE CLAIMS ACTS METHODIST HEALTH SYSTEM ADMINISTRATIVE Formulated: 6/19/07 Reviewed: Revised: Effective: 10/30/07 TITLE: DETECTING FRAUD AND ABUSE AND AN OVERVIEW OF THE FEDERAL AND STATE FALSE CLAIMS ACTS PURPOSE: Methodist

More information

Puerto Rican Family Institute, Inc.

Puerto Rican Family Institute, Inc. Puerto Rican Family Institute, Inc. Stronghold for Families, a Pathfinder for Children Corporate Compliance Program Plan - 2014 Updated by: Approved by: Yolanda Alicea Winn, LCSWR Vice President/Corporate

More information

Policies and Procedures SECTION:

Policies and Procedures SECTION: PAGE 1 OF 5 I. PURPOSE The purpose of this Policy is to fulfill the requirements of Section 6032 of the Deficit Reduction Act of 2005 by providing to Creighton University employees and employees of contractors

More information

UPDATED. OIG Guidelines for Evaluating State False Claims Acts

UPDATED. OIG Guidelines for Evaluating State False Claims Acts UPDATED OIG Guidelines for Evaluating State False Claims Acts Note: These guidelines are effective March 15, 2013, and replace the guidelines effective on August 21, 2006, found at 71 FR 48552. UPDATED

More information

FEDERAL LAWS RELATING TO FRAUD, WASTE AND ABUSE

FEDERAL LAWS RELATING TO FRAUD, WASTE AND ABUSE FEDERAL LAWS RELATING TO FRAUD, WASTE AND ABUSE FEDERAL CIVIL FALSE CLAIMS ACT The federal civil False Claims Act, 31 U.S.C. 3729, et seq., ( FCA ) was originally enacted in 1863 to combat fraud perpetrated

More information

Compliance and Ethics Program

Compliance and Ethics Program Compliance and Ethics Program Compliance and Ethics Program Introduction Inova, including its corporate subsidiaries, is committed to promoting an organizational culture that encourages ethical conduct

More information

Information Memo Securities Law June 2011

Information Memo Securities Law June 2011 www.bsk.com Information Memo Securities Law June 2011 SEC Implements Dodd-Frank Whistleblower Provisions The Securities and Exchange Commission s final rules 1 implementing Section 21F of the Securities

More information

Compliance. TODAY June 2012. Meet Lanny A. Breuer. Assistant Attorney General, Criminal Division, U.S. Department of Justice.

Compliance. TODAY June 2012. Meet Lanny A. Breuer. Assistant Attorney General, Criminal Division, U.S. Department of Justice. Compliance TODAY June 2012 a publication of the health care compliance association www.hcca-info.org Meet Lanny A. Breuer Assistant Attorney General, Criminal Division, U.S. Department of Justice See page

More information

Compliance Plan False Claims Act & Whistleblower Provisions Purpose/Policy/Procedures

Compliance Plan False Claims Act & Whistleblower Provisions Purpose/Policy/Procedures CATHOLIC CHARITIES OF THE ROMAN CATHOLIC DIOCESE OF SYRACUSE, NY and TOOMEY RESIDENTIAL AND COMMUNITY SERVICES Compliance Plan False Claims Act & Whistleblower Provisions Purpose/Policy/Procedures Purpose:

More information

Policies and Procedures: WVUPC Policy Pursuant to the Requirements of the Deficit Reduction Act of 2005

Policies and Procedures: WVUPC Policy Pursuant to the Requirements of the Deficit Reduction Act of 2005 POLICY/PROCEDURE NO.: B-17 Effective date: Jan. 1, 2007 Date(s) of review/revision: Nov. 1, 2015 Policies and Procedures: WVUPC Policy Pursuant to the Requirements of the Deficit Reduction Act of 2005

More information

Antifraud program and controls assessment grid*

Antifraud program and controls assessment grid* Advisory Services Antifraud program and * Fraud risks & controls February 2008 *connectedthinking 2008 PricewaterhouseCoopers LLP. All rights reserved. PricewaterhouseCoopers refers to PricewaterhouseCoopers

More information

HACKENSACK UNIVERSITY MEDICAL CENTER Administrative Policy Manual

HACKENSACK UNIVERSITY MEDICAL CENTER Administrative Policy Manual HACKENSACK UNIVERSITY MEDICAL CENTER Administrative Policy Manual Fraud and Abuse Prevention DRA Compliance Policy #: 1521 Original Issue: December, 2007 Page 1 of 6 Policy It is the policy of Hackensack

More information

CODE OF ETHICS AND BUSINESS CONDUCT

CODE OF ETHICS AND BUSINESS CONDUCT CODE OF ETHICS AND BUSINESS CONDUCT Date of Issue: 22 January 2015 Version number: 2 LUXFER HOLDINGS PLC Code of Ethics and Business Conduct Luxfer Holdings PLC is committed to conducting its business

More information

Establishing a Compliance System to Address the New Ethics Requirements: Common Pitfalls for Nonprofit Grant Recipients

Establishing a Compliance System to Address the New Ethics Requirements: Common Pitfalls for Nonprofit Grant Recipients Establishing a Compliance System to Address the New Ethics Requirements: Common Pitfalls for Nonprofit Grant Recipients Association of Corporate Counsel Nonprofit Organizations Committee Legal Quick Hit

More information

Inside The Proposed DFARS Business Systems Rule

Inside The Proposed DFARS Business Systems Rule Portfolio Media. Inc. 860 Broadway, 6th Floor New York, NY 10003 www.law360.com Phone: +1 646 783 7100 Fax: +1 646 783 7161 customerservice@law360.com Inside The Proposed DFARS Business s Rule Law360,

More information

Alliance for Better Health Care, LLC

Alliance for Better Health Care, LLC Alliance for Better Health Care, LLC ORGANIZATIONAL POLICY FALSE CLAIMS ACT AND WHISTLEBLOWER PROVISIONS Page 1 of 5 EFFECTIVE DATE: NUMBER: March 2015 ORIGINATOR: Corporate Compliance Officer CONCURRENCE:

More information

Top 10 Compliance Risks For GSA Schedule Contractors

Top 10 Compliance Risks For GSA Schedule Contractors Top 10 Compliance Risks For GSA Schedule Contractors October 31, 2013 12pm EST Albert B. Krachman, Esq. Partner Blank Rome LLP 600 New Hampshire Ave, NW Washington, D.C. 20037 Tel: 202.772.5812 Krachman@BlankRome.com

More information

Compliance Requirements for Healthcare Carriers

Compliance Requirements for Healthcare Carriers INFORMATION DRIVES SOUND ANALYSIS, INSIGHT REGULATORY COMPLIANCE ADVISORY Compliance Requirements for Healthcare Carriers Introduction With the introduction of the new healthcare exchanges in January 2014

More information

Compliance with Applicable Federal and State Laws - False Claims Act and Similar Laws

Compliance with Applicable Federal and State Laws - False Claims Act and Similar Laws Laws - False Claims Act and Similar Laws Purpose The purpose of this policy ( Policy ) is to provide information regarding: the federal and state False Claims Acts ( FCA ), related administrative remedies

More information

Providers are expected to conduct their business activities in full compliance with all applicable state and federal laws.

Providers are expected to conduct their business activities in full compliance with all applicable state and federal laws. 8. Compliance KP strives to demonstrate high ethical standards in its business practices. The Agreement details specific laws and contractual provisions with which you are expected to comply. This section

More information

Sample Healthcare Compliance Program

Sample Healthcare Compliance Program P.O. Box 153 Shell, WY 82441 307-765-2241 (direct) 888-286-2095 (e-fax) info@hcma-consulting.com www.hcma-consulting.com Sample Healthcare Compliance Program 1. Introduction COMPANY is committed to establishing

More information

Prevention of Fraud, Waste and Abuse

Prevention of Fraud, Waste and Abuse Procedure 1910 Responsible Office: Yale Medical Group Effective Date: 01/01/2007 Responsible Department: Administration Last Revision Date: 09/20/2013 Prevention of Fraud, Waste and Abuse Policy Statement...

More information

CODE OF CONDUCT. Providers, Suppliers and Contractors

CODE OF CONDUCT. Providers, Suppliers and Contractors CODE OF CONDUCT Providers, Suppliers and Contractors Table of Contents Code of Conduct... Honesty and integrity... Quality and Service... Responsibilities of Providers, Suppliers and Contractors... Compliance

More information

UNIVERSAL INSURANCE HOLDINGS, INC. CODE OF BUSINESS CONDUCT AND ETHICS. Revised as of March 3, 2014

UNIVERSAL INSURANCE HOLDINGS, INC. CODE OF BUSINESS CONDUCT AND ETHICS. Revised as of March 3, 2014 I. Statement of Policy UNIVERSAL INSURANCE HOLDINGS, INC. CODE OF BUSINESS CONDUCT AND ETHICS Revised as of March 3, 2014 Universal Insurance Holdings, Inc. ( UIH ) and its subsidiaries (collectively,

More information

CORPORATE COMPLIANCE PROGRAM

CORPORATE COMPLIANCE PROGRAM CORPORATE COMPLIANCE PROGRAM BACKGROUND AND POLICY: The Oakwood Accountable Care Organization, LLC. ( ACO ) corporate policy relating to compliance with applicable laws and regulations is embodied in this

More information

North Shore LIJ Health System, Inc.

North Shore LIJ Health System, Inc. North Shore LIJ Health System, Inc. POLICY TITLE: Detecting and Preventing Fraud, Waste, Abuse and Misconduct POLICY #: 800.09 System Approval Date: 6/23/14 Site Implementation Date: Prepared by: Office

More information

ADMINISTRATIVE POLICY MANUAL

ADMINISTRATIVE POLICY MANUAL SUPERSEDES: New PAGE: 838.00 POLICY: 1. It is the policy of Onondaga County hereinafter referred to as the County, to comply with all applicable federal, state and local laws and regulations, both civil

More information

POLICY SUBJECT: EFFECTIVE DATE: 5/31/2013. To be reviewed at least annually by the Ethics & Compliance Committee COMPLIANCE PLAN OVERVIEW

POLICY SUBJECT: EFFECTIVE DATE: 5/31/2013. To be reviewed at least annually by the Ethics & Compliance Committee COMPLIANCE PLAN OVERVIEW Compliance Policy Number 1 POLICY SUBJECT: EFFECTIVE DATE: 5/31/2013 Compliance Plan To be reviewed at least annually by the Ethics & Compliance Committee COMPLIANCE PLAN OVERVIEW Sound Inpatient Physicians,

More information

CODE OF CONDUCT I. POLICY

CODE OF CONDUCT I. POLICY CODE OF CONDUCT American Ambulance continually strives to provide high quality emergency care and medical transportation services to our patients, and to maintain high standards of integrity in our dealings

More information

ANTI-FRAUD POLICY Adopted August 13, 2015

ANTI-FRAUD POLICY Adopted August 13, 2015 ANTI-FRAUD POLICY Adopted August 13, 2015 Introduction The Board of Commissioners of the Housing Authority of the City of Muskogee (MHA) has established an anti-fraud policy to enforce controls and to

More information

0 HealthAlliance. of the ~udsoti vallevtm J / YOUR PARTNERS IN HEALTH

0 HealthAlliance. of the ~udsoti vallevtm J / YOUR PARTNERS IN HEALTH 0 HealthAlliance of the ~udsoti vallevtm J / YOUR PARTNERS IN HEALTH Policy: Compliance with Applicable Federal and State False Claims Acts Initiated: January 1,2010 Reviewed: Revised: Reference: Responsible

More information

TENNCARE POLICY MANUAL

TENNCARE POLICY MANUAL TENNCARE POLICY MANUAL Policy No: Pl 08-001 (Rev. 4) Subject: False Claims Act Policy Approval: Date: PURPOSE OF POLICY STATEMENT: The Bureau of TennCare is committed to its role in preventing health care

More information

Oklahoma FALSE CLAIMS LAWS

Oklahoma FALSE CLAIMS LAWS Oklahoma Company-affiliated facilities in Oklahoma must ensure that all employees, including management, and any contractors or agents are educated regarding the federal and state false claims statutes

More information

What is Independent Knowledge?

What is Independent Knowledge? DODD-FRANK ALERT DECEMBER 2010 SEC Proposes Dodd-Frank Whistleblower Rules New York Office 2 Park Avenue New York, New York 10016 Phone: (212) 592-1400 Fax: (212) 592-1500 Princeton Office 210 Carnegie

More information

POLICY AND STANDARDS. False Claims Laws and Whistleblower Protections

POLICY AND STANDARDS. False Claims Laws and Whistleblower Protections POLICY AND STANDARDS Corporate Policy Applicability: Magellan BH (M) NIA (N) ICORE (I) Magellan Medicaid Administration (A) Corporate Policy: Policy Number: Policy Name: Date of Inception: January 1, 2007

More information

Evergreen Solar, Inc. Code of Business Conduct and Ethics

Evergreen Solar, Inc. Code of Business Conduct and Ethics Evergreen Solar, Inc. Code of Business Conduct and Ethics A MESSAGE FROM THE BOARD At Evergreen Solar, Inc. (the Company or Evergreen Solar ), we believe that conducting business ethically is critical

More information

13.4 PHI Air Medical Code of Conduct

13.4 PHI Air Medical Code of Conduct I. PURPOSE PHI Air Medical continually strives to provide high quality emergency care and medical transportation services to our patients, and to maintain high standards of integrity in our dealings with

More information

A Bill Regular Session, 2015 SENATE BILL 830

A Bill Regular Session, 2015 SENATE BILL 830 Stricken language would be deleted from and underlined language would be added to present law. State of Arkansas 90th General Assembly A Bill Regular Session, 2015 SENATE BILL 830 By: Senator D. Sanders

More information

FRAUD AND ABUSE (SECTION-BY-SECTION ANALYSIS)

FRAUD AND ABUSE (SECTION-BY-SECTION ANALYSIS) FRAUD AND ABUSE (SECTION-BY-SECTION ANALYSIS) (Information compiled from the Democratic Policy Committee (DPC) Report on The Patient Protection and Affordable Care Act and the Health Care and Education

More information

DEFENSE CONTRACT AUDIT AGENCY DEPARTMENT OF DEFENSE 8725 JOHN J. KINGMAN ROAD, SUITE 2135 FORT BELVOIR, VA 22060-6219

DEFENSE CONTRACT AUDIT AGENCY DEPARTMENT OF DEFENSE 8725 JOHN J. KINGMAN ROAD, SUITE 2135 FORT BELVOIR, VA 22060-6219 DEFENSE CONTRACT AUDIT AGENCY DEPARTMENT OF DEFENSE 8725 JOHN J. KINGMAN ROAD, SUITE 2135 FORT BELVOIR, VA 22060-6219 IN REPLY REFER TO PAS 730.3.B.2 July 23, 2009 09-PAS-014(R) MEMORANDUM FOR REGIONAL

More information

Policy and Procedure: Corporate Compliance Topic: False Claims Act and Whistleblower Provisions, Deficit Reduction Act

Policy and Procedure: Corporate Compliance Topic: False Claims Act and Whistleblower Provisions, Deficit Reduction Act Policy and Procedure: Corporate Compliance Topic: False Claims Act and Whistleblower Provisions, Deficit Reduction Act SCOPE OF POLICY This policy applies to all CFS employees, including trainees, volunteers,

More information

BARRICK GOLD CORPORATION

BARRICK GOLD CORPORATION BARRICK GOLD CORPORATION Code of Business Conduct and Ethics Introduction Barrick s success is built on a foundation of personal and professional integrity and commitment to excellence. As a company and

More information

False Claims / Federal Deficit Reduction Act Notice Help Stop Healthcare Fraud, Waste and Abuse: Report to the Firelands Corporate Compliance Officer

False Claims / Federal Deficit Reduction Act Notice Help Stop Healthcare Fraud, Waste and Abuse: Report to the Firelands Corporate Compliance Officer 1111 Hayes Avenue Sandusky, OH 44870 www.firelands.com False Claims / Federal Deficit Reduction Act Notice Help Stop Healthcare Fraud, Waste and Abuse: Report to the Firelands Corporate Compliance Officer

More information