Policy Manual sample

MDT Home Health Care Agency, Inc. AGENCY ZERO FRAUD TOLERANCE POLICY PURPOSE: To ensure employees participate in the Agency’s effort to avoid/prevent any FRAUD activity that may conflict with the interests of the agency, and any State/Federal/Private programs. POLICY: The Agency expects all of its employees to understand and be aware of potential situations where the FRAUD will be not tolerated. PROCEDURE: 1. All employees will report to their immediate supervisor any actions/omission in/or employment, services that interacts with the Agency Fraud prevention Policy, but not limited to: A. Employee participation in any business transactions where there might appear to be a conflict between the employee's personal interest and that of the Agency’s effort to prevent fraud. B. Employee participation in any activity/cover for services not provided. C. Outside employment that interferes with satisfactory performance of an employees duties and responsibilities for the Agency. D. Any outside relationship, financial interest, or participation in a business transaction which might appear to influence the performance of an employee's duties and responsibilities for the Agency. E. Acceptance/giving of gifts, kick back, including cash payments, fees, services, discounts, valuables, privileges or other favors which would or might appear to improperly influence an employee in the performance of the employee's duties and responsibilities for the Agency. (Illegal remuneration) F. Participated in any action to Alter Costs. G. Use un-licensed person to perform their duties, or licensed without authorization (misrepresentation). H. Not report any sign of Abuse: verbal, physical, economical or any other form. I. Participate in any act of Identity/Insurance ID theft. J. Permit unnecessary or Duplicate services. K. Altering Claims, Billing forms, Invoices, Expenses, or any other accounting related issue. (Over-billing) L. Non-compliance with approved/ordered scheduled of visits, and Reporting Guidelines, including technically corrected transcribing services if used. M. Participate in fraudulent Records, Notes, Signatures, Reports. 2. If a fraud action is discovered or suspected the supervisor/manager and employee will discuss its impact with the Administrator. 3. After the above discussion, a recommendation may be made for the employee to end his/her association with the entity or the Agency within a specified period of time, including the correspondent report to any Regulatory Agency. 4. The failure of an employee to cease activity that management determines to be a fraud action will subject the employee to disciplinary action up to and including termination. Home Health Agency Policies A-153