CMS Issues FAQs on Employee Education About the False Claim Act
On February 8, 2005, President Bush signed into law the Deficit Reduction Act (the "DRA"). Among the most noteworthy provisions included in the DRA is a provision that requires employee education about the False Claims Act ("FCA") and applicable laws that protect, and even reward, employees who act as whistleblowers. The DRA specifically requires entities that receive or make annual payments of at least $5,000,000 pursuant to any state Medicaid program to establish written policies for employees that explain the provisions of the FCA, any state false claims laws and the applicable administrative remedies. The policies must also include a description of whistleblower protections and an explanation of internal policies that aim to prevent fraud and abuse. An employer must include a discussion of these matters in the employer's employee handbook. Entities that fail to comply risk exclusion from the Medicaid program.
Despite the fact that the deadline for compliance has passed, many in the industry have complained that the law included far too many ambiguities. In response, the Centers for Medicare and Medicaid Services has issued answers to frequently asked questions. The sixteen page guidance document covers many issues, including providing a more clear definition of the term "entity" and describing whether health systems with subsidiaries having less than $5,000,000 in payments but that exceed this amount collectively must have in place the required policies.
If you or anyone in your pharmaceutical or medical device compliance department needs training in this area. You should consider the Health Care Compliance Certification Program at Seton Hall Law School. The next program is scheduled for June 25 to 28, 2007. See the website, law.shu.edu, for further information