Fraud and Abuse in Home Care Illegal Remuneration/Non-Solicitation of Referrals • The Agency fully complies with the state’s solicitation of patients/clients and failure to disclose regulations as provided in the Texas Occupations Code, Chapter 102. • "Soliciting Patients Offense” means a person commits an offense if the person knowingly offers to pay or agrees to accept, directly or indirectly, overtly or covertly any remuneration in cash or in kind to or from another for securing or soliciting a patient or patronage for or from a person licensed, certified, or registered by a state health care regulatory agency. • “Failure to Disclose Offense” means a person commits an offense if the person, in a manner otherwise permitted under Section 102.001 of the Texas Occupations Code, accepts remuneration to secure or solicit a patient for a licensed, certified, or registered by a state health care regulatory agency and does not, at the time of the initial contact and at the time of referral disclose to the patient the person’s affiliation, if any, with the person for whom the patient is secured or solicited and the person will receive, directly or indirectly, remuneration for securing or soliciting the patient Billing Process/Advance Beneficiary Notice/False Claims • All employees have a responsibility to report suspected and actual violations resulting in false claims and/or billing fraud and/or abuse to their supervisor and/or the Compliance Officer immediately. • Suspected and actual violations resulting in false claims, billing fraud and/or abuse may be made to the Texas Health and Human Services Office of Inspector General either online at https://oig.hhs.texas.gov/report-fraud-waste-or-abuse or by calling the toll free hotline at 1- 800-436-6184. Online Bookmark Title of Policy Illegal Remuneration/Non-Solicitation of Referrals TX Rights and Ethics (RI) Billing Process/Advance Beneficiary Notice/False Claims TX Human Resources and Personnel Administration Employee Education In Texas, Mandated in-services include: • Rights of the Elderly (for staff who provide care to patients sixty [60] years old or older) Online Bookmark Title of Policy Admit Pack Rights of Elderly TX Human Resources (HR) Agency In-services and Education TX
