The Office of Healthcare Compliance office works to ensure compliance with federal and state laws and regulations as well as University policies. Healthcare compliance at UConn Health encompasses patient care, billing and reimbursement practices and employee and student education.
As healthcare becomes increasingly complex, practitioners must understand and adhere to applicable laws to avoid consequences such as negative publicity, lawsuits, fines, loss of funding, or exclusion from participation in federal healthcare programs.
Q: What is fraud?
Fraud is knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program, or to obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program.
Q: How can I report suspected fraud?
You can report to the Office of Healthcare Compliance, the Reportline, or externally to the Office of the Inspector General.
Q: What are some examples of fraud?
- Knowingly billing for services not furnished or supplies not provided, including billing appointments that the member/patient failed to keep
- Knowingly altering claim forms, medical records, or receipts to receive a higher payment