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Thompson Coburn Health Care
Law Alert
“DEFRA” May Require Changes
to Your Compliance Program, Training Materials and Employee Handbooks
As part of the Deficit Reduction
Act of 2005 (“DEFRA”) signed into law on February 8, 2006, entities that
receive at least $5 million annually in Medicaid payments are required
to:
Establish written policies for all
employees, contractors and agents of the entity that provide detailed
information about the Federal False Claims Act, Federal administrative
remedies for false claims and statements, any state laws which pertain to
civil or criminal penalties for false claims or statements, any
"whistleblower" protections under these laws, and the role of these laws
in preventing fraud, waste and abuse in Federal health care programs;
- Include in these written policies information
about the entity's policies and procedures for preventing and detecting
fraud, waste and abuse; and
- Include in any employee handbook a specific
discussion of the laws described above, the rights of employees to be
protected as "whistleblowers," and the entity's policies and procedures
for preventing and detecting fraud, waste and abuse.
- These requirements are a condition of Medicaid
payment for the
entity. This means that if an entity fails to comply with these
provisions by January 1, 2007, its
requests for Medicaid payment could be considered "false claims."
Health care providers should review
their compliance programs and other compliance documents, as well as any
employee handbooks, to ensure that they meet the new DEFRA requirements.
If you have any questions regarding these new requirements, or desire
assistance in preparing for the January 1, 2007 deadline, please contact
me or any member of the Thompson Coburn Health Care Group.
The full text of DEFRA can be found
at:
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=109_cong_bills&docid=f:s1932enr.txt.pdf |