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CUMPLIMIENTO, Es la ley.

El propósito de los programas de cumplimiento es promover el cumplimiento organizacional de las leyes federales y estatales aplicables, y de los requisitos de atención médica de los pagadores privados. Un programa de cumplimiento eficaz puede ayudar a proteger las prácticas contra el fraude, el abuso, el despilfarro y otras áreas potenciales de responsabilidad.

HOPE está comprometida con un sólido Programa de Cumplimiento que previene, detecta y responde a conductas que son inconsistentes con las leyes federales y estatales y con nuestros valores.

Vídeos de formación

HEAT Training on the FFCA / Federal False Claims Act & Federal Whistleblower Protections | provided by the Health Care Fraud Prevention and Enforcement Action Team

- The Federal False Claims Act & Federal Whistleblower Protections 

https://youtu.be/BbZ78QTLztQ

- How to Report Fraud to the OIG 

https://youtu.be/nH7p30j7dOw

HEAT Training on the OIG’s Self Disclosure Protocol | provided by the Health Care Fraud Prevention and Enforcement Action Team

- OIG Self Disclosure Protocol 

https://youtu.be/QKUOzbV1zSU

HEAT Training on the Importance of Documentation | provided by the Health Care Fraud Prevention and Enforcement Action Team

- Importance of Documentation

https://youtu.be/1M7kKGqSa14

HEAT Training on the Provider Self-Referral Law | provided by the Health Care Fraud Prevention and Enforcement Action Team

- Provider Self-Referral Law 

https://youtu.be/hmWG4o5zrvQ

HEAT Training on the Anti-Kickback Statute | provided by the Health Care Fraud Prevention and Enforcement Action Team

- Anti-Kickback Statute 

https://youtu.be/a4KhqqeAaUg

HEAT Training on the OIG Exclusion Requirement | provided by the Health Care Fraud Prevention and Enforcement Action Team

- OIG Exclusion Checks 

https://youtu.be/R3vAeH9XQQs

Tennessee Medicaid Compliance Training | provided by Amerigroup, a TennCare Managed Care Provider | This training guide includes an overview of the following topics:

*  Federal & Tennessee Medicaid False Claims Act

*  Federal & Tennessee Whistleblower Protections

*  Reporting Healthcare Fraud In Tennessee

*  Nondiscrimination & Title VI

*  Age Discrimination

*  Rehabilitation Act of 1973

*  TennCare Member Rights

*  Deficit Reduction Act (DRA) of 2005

- Medicaid Compliance 

https://provider.amerigroup.com/docs/gpp/TN_Provider_Non-discrimination_Training.pdf?v=202010310023

 

https://provider.amerigroup.com/docs/gpp/TN_CAID_FalseClaimsEducation.pdf?v=202010310023

 

https://provider.amerigroup.com/docs/gpp/TN_CAID_ComplianceWebinar.pdf?v=202010310023

TennCare Nondiscrimination Compliance Training | provided by the State of Tennessee Division of Health Care Finance & Administration

-  Nondiscrimination Training 

https://www.tn.gov/content/dam/tn/tenncare/documents/TennCareComplaintProcedures.pdf

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