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DRA Requires Employee Education on Compliance
November 10, 2006

The Deficit Reduction Act (DRA) of 2005 (Public Law 109-171) in § 6032, Employee Education About False Claims Recovery, requires any entity that receives or makes annual payments under the State Plan of at least $5 million in Medicaid funds to "establish written policies for all employees of the entity (including management), and of any contractor or agent of the entity, that provide detailed information about the federal False Claims Act…administrative remedies for false claims and statements…any State laws pertaining to civil or criminal penalties for false claims and statements, and whistleblower protections under such laws, with respect to the role of such laws in preventing and detecting fraud, waste, and abuse in Federal health care programs" and detailed information about the entity’s policies and procedures for detecting and preventing fraud, waste, and abuse. The law further requires the entity to include in any employee handbook a specific discussion of the above laws, the rights of whistleblowers, and the entity’s policies and procedures for detecting and preventing fraud, waste, and abuse. The above requirements are effective January 1, 2007.

The Department of Health and Human Services (DHHS) has not issued guidance for compliance with § 6032. Until guidance is issued, and in the interest of time, providers may want to review an Issue Brief, New Medicaid Compliance Issues from the Deficit Reduction Act, by Mary Thornton, BSRN, MBA, from the National Council for Community Behavioral Healthcare (NCCBH). This Issue Brief provides suggestions to assist providers with readiness for January 1 in the absence of specific guidance. Also available is a handout from an NCCBH Meet Me Call, Deficit Reduction Act and the False Claims Act, presented by Ms. Thornton. This document may be helpful to providers’ efforts in compliance with § 6032 of the DRA. PCPA members may also want to review several of the compliance guidance and compliance resource materials documents that are posted on the DHHS, Office of the Inspector General web site (www.oig.hhs.gov/fraud/complianceguidance.html#2).

Please contact Betty Simmonds with questions.

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