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Punishment for fraudulent and abusive activity can range from provider education and a request for overpayment, to assessment of Civil Monetary Penalties of up to $10,000 per service billed and/or criminal prosecution.
In one of the largest settlements reached by the Department of Justice(DOJ), "Gambro Healthcare agreed to pay more than $350 million in criminal fines and civil penalties to settle allegations that it submitted false claims"(Department of Justice, 2004)...
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To ensure future compliance, Gambro established a Corporate Compliance Program which included policies and procedures, an education and training component, mechanisms for ongoing monitoring and auditing of operations to assess compliance, mechanisms for employees to anonymously report incidents of noncompliance, disciplinary actions for individuals violating compliance policies and procedures, and oversight of the compliance program by Compliance Officers and a Compliance Committee...
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