Laura Bennet
MAST 1520 Unit 2 Assignment
Module 2 – Compliance Complete the following question.
In your own words, please describe how a compliance plan can be helpful to an office that is investigated for fraud related to submission of medical claims.
A compliance plan plays a crucial role in safeguarding an office under investigation for fraud-related medical claims. A well-structured compliance plan helps educate all workforce levels about legal requirements, including
the False Claims Act. Employees can avoid unintentional violations and ensure accurate claims submission by understanding the law.
The plan establishes procedures to detect and prevent fraud, waste, and abuse incidents. This includes methods like:
Monitoring the accuracy of resolved claims.
Allowing employees to report potential issues confidentially.
Identifying individuals or entities disqualified from federal programs.
The Compliance Officer oversees the program's effectiveness and ensures that incidents are appropriately handled, discussed, and reported to law enforcement agencies.
The plan emphasizes ethical behavior and accurate record-keeping related to services payable by federal
health care programs.
If fraud and abuse incidents are identified, systematic changes and corrective actions are implemented to prevent further offenses.
Compliance plans are essential for maintaining the organization's legal compliance, trust, and integrity.
