| As required by the Deficit Reduction Act of 2005, the purpose of this policy is to inform employees, contractors, and agents who furnish or authorize the furnishing of Medicare, Medi-Cal, and other federally-funded services about federal and State laws dealing with false claims.
An additional purpose is to inform employees and contractors about the Los Angeles County Department of Mental Health’s (DMH/Department) commitment to follow all requirements that govern program and fiscal activities.
This policy revision incorporates changes in the federal and State False Claims Act.
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| As part of its effort to comply with all federal and State laws and regulations intended to prevent health care fraud and abuse, DMH will inform its employees, and contractors and agents who furnish or authorize the furnishing of federally funded services (including but not limited to Medi-Cal and Medicare services), of the laws related to the submission of false claims or the making of false statements.
The laws described in this policy are intended to control fraud in federal and State health care programs by giving certain governmental agencies the authority to seek out, investigate and prosecute violations. Enforcement activities are pursued at three different levels: criminal, civil and administrative. This provides a wide range of remedies to help battle fraud and abuse. Additionally, whistleblower statutes and protections for individuals reporting fraud, waste and abuse encourage the reporting of this misconduct by creating financial incentives and employment protections.
This policy includes the following information concerning tools used to fight fraud, waste and abuse:
- A summary of the Federal False Claims Act
- A summary of federal administrative remedies found in federal law for the submission of false claims
- A summary of laws of the State of California that impose civil or criminal penalties for false claims or statements related to providing health care
The Code of Organizational Conduct, Ethics, and Compliance describes DMH’s commitment to complying with all relevant legal and program requirements as well as upholding the highest in professional and personal conduct in order to detect and prevent fraud, waste and abuse of federal health care programs.
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