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Policy & Procedure

Reporting of Compliance Concerns and Non-Retaliation Policy and Procedure

Purpose:

Saratoga Bridges recognizes that a critical aspect of its compliance program is the establishment of a culture that promotes prevention, detection, and resolution of instances of conduct that do not conform to federal and state requirements, as well as the organization’s ethical and business policies.  To promote this culture, Saratoga Bridges established a compliance reporting process and a strict non-retaliation policy to protect employees and others who report problems and concerns in good faith from retaliation.

Any form of retaliation or retribution can undermine the compliance resolution process and result in a failure of communication channels in the organization.

Under New York law, employees who report certain kinds of illegal or improper activities to a supervisor or to a government authority, or who refuse to participate in illegal activity of the employer, are protected against retaliatory personnel actions such as discharge. In order to be protected against retaliation, the employee must first report the violation to his or her supervisor and give the employer a reasonable opportunity to correct the problem.

Several federal and state laws enable the government to impose administrative remedies, civil sanctions, and criminal penalties for false claims and statements made in connection with federal health care programs. For example, the federal False Claims Act allows theUnited Statesgovernment or a private citizen to sue an individual or an entity for knowingly making certain false claims in connection with government business, such as knowingly submitting improper bills to a federal health care program. Under some circumstances, a private citizen who initiates an action under the False Claims Act may be entitled to a portion of the court award or settlement that is recovered by the government. An employee who brings or participates in a False Claims Act suit is protected by law from certain retaliatory actions by the employer.

Policy:

  1. All employees have an affirmative duty and responsibility for promptly reporting any known or suspected misconduct, including actual or potential violations of laws, regulations, policies, procedures, Saratoga Bridges Compliance Plan or Professional Conduct Policy.
  2. The “open-door policy” will be maintained at all levels of management to encourage employees to report problems and concerns.
  3. Saratoga Bridges will provide training in this policy and procedure to all its employees, contractors and agents. This training will be provided to all new employees as part of the new employee orientation.
  4. Saratoga Bridges will perform billing activities in a manner consistent with the regulations and requirements of third party payors, including Medicaid and Medicare.
  5. Saratoga Bridges will conduct regular auditing and monitoring procedures as part of its efforts to assure compliance with applicable regulations.
  6. Any employee, contractor or agent who has any reason to believe that anyone is engaging in false billing practices or false documentation of services is expected to report the practice according toSaratogaBridges’ Reporting of Compliance Concerns and Non-Retaliation Policy and Procedure.
  7. Saratoga Bridges will maintain a Compliance Hotline. Employees may report their compliance concerns confidentially to the Compliance Officer through use of the Compliance Hotline.
  8. Any form of retaliation against an employee who reports a perceived problem or concern in good faith is strictly prohibited.
  9. Any employee who commits or condones any form of retaliation will be subject to discipline up to, and including, termination.
  10. Employees cannot exempt themselves from the consequences of their own misconduct by reporting the issue although self reporting may be taken into account in determining the appropriate course of action.

 

Procedures that apply to all employees:

  1. Knowledge of misconduct, including actual or potential violations of laws, regulations, policies, procedures, or the organization’s Professional Conduct Policy, must be immediately reported to management, Human Resources Department, the Compliance Officer, or the Compliance Hotline.
  2. Confidentially will be maintained to the extent that is practical and allowable by law. Employees should be aware that Saratoga Bridges is legally required to report certain types of crimes or potential crimes and infractions to external governmental agencies.
  3. Employees may report their compliance concerns confidentially to the Compliance Hotline and provide his or her identity. Callers should be aware, however, that it may not be possible to preserve anonymity if they identify themselves, provide other information that identifies them, the investigation reveals their identity, or if they inform others that they have called the Compliance Hotline.
  4. If the caller wishes to make the report anonymously to the Compliance Hotline, no attempt will be made to trace the source of the call or identity of the person making the call.
  5. The Compliance Hotline number will be published and visibly posted in a manner consistent with employee notification in locations frequented by Saratoga Bridges employees.
  6. Saratoga Bridges will not impose any disciplinary or other action in retaliation against individuals who make a report or complaint in good faith regarding a practice that the individual believes may violate the Saratoga Bridge’s Corporate Compliance Plan, Professional Conduct Policy, its Compliance Policies and Procedures, or any of the laws, rules, or regulations by which Saratoga Bridges is governed.
  7. Saratoga Bridges strictly prohibits its employees from engaging in any act, conduct or behavior which results in, or is intended to result in, retaliation against any employee for reporting his or her concerns relating to a possible violation of Saratoga Bridges’ Corporate Compliance Plan, Professional Conduct Policy, its Compliance Policies and Procedures, or any of the laws, rules or regulations by which Saratoga Bridges is governed.
  8. If an employee believes in good faith that he has been retaliated against for reporting a compliance complaint or concern or for participating in any investigation of such a report or complaint, the employee should immediately report the retaliation to the Compliance Officer or the Compliance Hotline. The report should include a thorough account of the incident(s) and should include the names, dates and specific events, the names of any witnesses and the location or name of any document that supports the alleged retaliation.
  9. Knowledge of a violation or potential violation of this policy must be reported directly to the Compliance Officer or the Compliance Hotline.

 

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