One key objective of the compliance plan in a healthcare organization is to create a secure and effective reporting process, thereby avoiding qui tam lawsuits against the facility.
What is a qui tam lawsuit, and how can we avoid them? Can you envision any situation in which you yourself might file a qui tam lawsuit?
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A qui tam law suit is where a whistle blower law suit as a part of the false claims act. The lawsuit is most commonly in the health care sector and from where a government regulation is ignored or simply not followed. One of my departments I currently manage is a couple sleep centers. This has happened in other sleep centers.
Independently owned sleep centers are usually the ones I have heard of that have gotten into trouble with Medicare and whistle blowers. In a sleep center a registered sleep tech must aquire the sleep studies. If a non registered sleep technologist runs a sleep test for any government insurance this is a violation of CMS regulations.
This was a big change a few years ago. Hospital based sleep centers have compliance teams, audits and many people that help identify health care changes. IDTF sleep centers are usually phsycian owned that are bit more lax. A sleep center near our lab got hit with a huge Medicare fine. The report came from a registered sleep tech that was fired after she complained to the owner of the lab that she didnt feel comfortable working with the non registered sleep tech.