118 Employee Education About False Claims Recovery
Original Approval Date: September 19, 2007
Revision Effective: July 15, 2009
Reviewed: September 21, 2022
Purpose: To provide information about the role of certain federal and state laws in preventing and detecting fraud, waste, and abuse and to provide education about protections provided by these laws.
Scope: This policy applies to all employees (including management), contractors (other than provider agencies), Board Members and agents of the Tri-County Board of Recovery and Mental Health Services.
Policy: The Tri-County Board of Recovery and Mental Health Services is committed to complying with all applicable federal and state laws and regulations. To further this policy and to comply with Section 6032 of the Deficit Reduction Act of 2005, the Tri-County Board of Recovery and Mental Health Services will provide the following information or any updated relevant information to all staff:
All employees (including management), contractors/consultants, Board Members and agents of the Tri-County Board of Recovery and Mental Health Services are afforded federal protection under the Federal False Claims Act (31 U.S.C sections 3729 – 3733). This act permits private citizens to sue, for civil damages, anyone who has submitted a false claim to Ohio’s Medicaid program.
There are also Ohio state laws in existence which regulate the filing of false claims for Medicaid payment.
The Tri-County Board of Recovery and Mental Health Services does not provide direct services to Medicaid eligible consumers but there may be instances where, through performance of your professional duties, you may become aware of potential or alleged Medicaid fraud. If this occurs, the following actions should be taken:
Note: The Tri-County Board of Recovery and Mental Health Services is not authorized by ODJFS to specifically promulgate/implement policies and procedures for detecting and preventing fraud waste and abuse for the Medicaid program. ODJFS holds that primary responsibility.
EMPLOYEE ACKNOWLEDGEMENT:
I, ____________________ (please print name) acknowledge that I have received copies of the Tri-County Board of Recovery and Mental Health Service’s Employee Education About False Claims Recovery under the Deficit Reduction Act of 2005. The materials provided included discussion of pertinent laws related to the Act, and rights of employees to be protected as whistleblowers.
__________________ Signature Date
*A copy of this signed acknowledgement shall be placed in the employee’s personnel record.
Revision Effective: July 15, 2009
Reviewed: September 21, 2022
Purpose: To provide information about the role of certain federal and state laws in preventing and detecting fraud, waste, and abuse and to provide education about protections provided by these laws.
Scope: This policy applies to all employees (including management), contractors (other than provider agencies), Board Members and agents of the Tri-County Board of Recovery and Mental Health Services.
Policy: The Tri-County Board of Recovery and Mental Health Services is committed to complying with all applicable federal and state laws and regulations. To further this policy and to comply with Section 6032 of the Deficit Reduction Act of 2005, the Tri-County Board of Recovery and Mental Health Services will provide the following information or any updated relevant information to all staff:
- A November 9, 2006 Ohio Department of Job and Family Services (ODJFS) Medical Assistance Letter (MAL) No. 516;
- An Ohio Department of Job and Family Services’ document titled “Ohio Health Plan’s Procedures for Detecting Fraud, Waste and Abuse”; and
- An Ohio Department of Job and Family Services’ document titled “State and Federal False Claims Act and Whistleblower Protections”.
All employees (including management), contractors/consultants, Board Members and agents of the Tri-County Board of Recovery and Mental Health Services are afforded federal protection under the Federal False Claims Act (31 U.S.C sections 3729 – 3733). This act permits private citizens to sue, for civil damages, anyone who has submitted a false claim to Ohio’s Medicaid program.
There are also Ohio state laws in existence which regulate the filing of false claims for Medicaid payment.
The Tri-County Board of Recovery and Mental Health Services does not provide direct services to Medicaid eligible consumers but there may be instances where, through performance of your professional duties, you may become aware of potential or alleged Medicaid fraud. If this occurs, the following actions should be taken:
- If you are dealing directly with someone either in person, by telephone or through e-mail, inform them that they are responsible for determining whether or not to report their information to the Ohio Attorney General’s (OAG) office, Medicaid Fraud Control Unit (MFCU).
- Inform them they may file a report/allegation electronically through accessing the OAG website: www.ag.state.oh.us
- As soon as possible, inform the Executive Director of the Tri-County Board of Recovery and Mental Health Services of the details (who you were in contact with, their allegations, and information you shared with them and, if you know whether the OAG is being contacted.)
Note: The Tri-County Board of Recovery and Mental Health Services is not authorized by ODJFS to specifically promulgate/implement policies and procedures for detecting and preventing fraud waste and abuse for the Medicaid program. ODJFS holds that primary responsibility.
EMPLOYEE ACKNOWLEDGEMENT:
I, ____________________ (please print name) acknowledge that I have received copies of the Tri-County Board of Recovery and Mental Health Service’s Employee Education About False Claims Recovery under the Deficit Reduction Act of 2005. The materials provided included discussion of pertinent laws related to the Act, and rights of employees to be protected as whistleblowers.
__________________ Signature Date
*A copy of this signed acknowledgement shall be placed in the employee’s personnel record.
| 118_employee_acknowledgement_form.doc |
