Fraud, Waste, and Abuse Prevention Policy

I. PurposeThe purpose of this policy is to establish a culture of honesty, integrity, and accountability and to provide guidelines for the prevention, detection, and correction of fraud, waste, and abuse within the Carrie Tingley Hospital Foundation (the “Foundation”).

II. Policy StatementThe Foundation strictly prohibits any form of fraud, waste, and abuse. All employees, volunteers, board members, and other stakeholders are expected to act ethically and comply with all applicable laws and regulations.

III. Definitions

  • Fraud: Intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to themselves or some other person.
  • Waste: The misuse of Foundation resources or a mismanagement of Foundation assets or funds.
  • Abuse: Practices that are inconsistent with sound fiscal, business, or medical practices and result in an unnecessary cost to the Foundation, or in reimbursement for services that are not necessary or that fail to meet professionally recognized standards for health care.

IV. Procedures

  1. Reporting: Any suspected incidents of fraud, waste, or abuse should be reported immediately to the designated Compliance Officer or through the established anonymous reporting hotline.
  2. Investigation: All reported incidents will be investigated promptly and thoroughly. Confidentiality will be maintained to the extent possible.
  3. Corrective Action: If the investigation substantiates that fraud, waste, or abuse has occurred, the Foundation will take appropriate corrective action, which may include disciplinary action up to and including termination, and legal proceedings if necessary.
  4. Training: The Foundation will provide regular training to all employees and volunteers on recognizing and preventing fraud, waste, and abuse.
  5. Monitoring: The Foundation will conduct periodic audits and reviews to ensure compliance with this policy.

V. ResponsibilityAll members of the Foundation are responsible for the prevention and detection of fraud, waste, and abuse. Each individual is encouraged to report any concerns or suspicious activity.

VI. ReviewThis policy will be reviewed annually and updated as needed to ensure it meets all regulatory requirements and reflects best practices.