Remedial Measures and Discipline Flashcards

When an organization decides to exclude an individual from participation in its operations following a compliance violation, it must first check the:

Answer: OIG List of Excluded Individuals and Entities (LEIE) and SAM.gov

Before and after any employment or contracting action, organizations must screen against the LEIE and SAM.gov to ensure they do not employ or contract with federally excluded parties.

A 'root cause analysis' conducted as part of a corrective action plan should PRIMARILY answer which question?

Answer: Why did the violation occur and what systemic conditions enabled it?

Root cause analysis identifies the underlying systemic or process failures that allowed a violation to occur, enabling targeted corrective actions.

An employee alleges that they were wrongfully terminated in retaliation for reporting a compliance concern. Under the False Claims Act's anti-retaliation provisions, the employee may:

Answer: Seek reinstatement, double back pay, and attorneys' fees

The FCA's anti-retaliation provision (31 U.S.C. § 3730(h)) allows prevailing employees to recover reinstatement, double back pay, and attorneys' fees.

During a compliance audit, it is discovered that a department head had prior knowledge of ongoing billing fraud but failed to act. The MOST appropriate discipline for the department head is:

Answer: Discipline commensurate with their supervisory responsibility for failing to act, potentially including termination

Supervisors who knowingly fail to stop ongoing fraud share culpability and should face discipline proportional to their failure of oversight responsibility.

A corrective action plan is MOST effective when it includes which of the following mechanisms?

Answer: Defined milestones, accountability assignments, and ongoing monitoring to verify implementation

Effective corrective action plans assign accountability, set measurable milestones, and include ongoing monitoring to confirm that controls have been successfully implemented.

Which of the following BEST describes 'progressive discipline' as used in healthcare compliance programs?

Answer: Applying escalating sanctions starting with counseling and increasing to termination for repeated or serious violations

Progressive discipline applies graduated sanctions — from counseling to written warnings to termination — proportional to violation severity and the employee's disciplinary history.

After completing a self-disclosure to the OIG Self-Disclosure Protocol, the organization should expect the OIG to:

Answer: Acknowledge receipt, conduct its own review, and negotiate a settlement that may include a multiplier on the overpayment

The OIG reviews self-disclosures and typically negotiates a settlement requiring repayment at a multiplier (often 1.5×), which is lower than standard False Claims Act exposure.