Corporate Compliance

Hunterdon Healthcare System, Inc. demonstrates its commitment to fostering an ethical and moral environment by developing and maintaining a Corporate Compliance Program which promotes sound ethical practices and moral behavior and attempts to minimize instances of improper conduct by individuals throughout the Hunterdon Healthcare System.

Code of Conduct Statement

The Corporate Compliance Code of Conduct Statement provides guidance to all of our Hunterdon Healthcare System services and affiliates, trustees, officers, leadership associates, managers, supervisors, associates, contractors, volunteers, students and others and assists us in carrying out our daily activities within appropriate ethical and legal standards. Vendors and contractors of Hunterdon Healthcare are expected to abide by this Code of Conduct as a condition of providing products and/or services to Hunterdon Healthcare.  

 4 page PDF format (24KB)
Corporate Compliance Program - Code of Ethics 

Deficit Reduction Act

On February 8, 2006, the Deficit Reduction Act was signed into law by President Bush in an attempt to drastically reduce the national deficit.  One way the Deficit Reduction Act seeks to reduce the deficit is through increased emphasis on detecting and preventing fraud, waste and abuse within the states’ Medicaid programs.  In order to increase awareness of the laws regarding false claims under the Medicaid program, Section 6032 of the Deficit Reduction Act requires entities that receive or pay annual Medicaid payments of $5 million or more, such as Hunterdon Healthcare System to establish new written policies for all their employees, and the employees of their contractors and agents, which provide: detailed information regarding the federal False Claims Act; the administrative remedies for false claims and statements; and state law with civil or criminal penalties for false claims or statements; and the whistleblower protections under such laws.

Hunterdon Healthcare System has developed policies to address the requirements of the Deficit Reduction Act.  These policies are available to all employees, vendors, and contractors.  Highlights from these policies are provided below, followed by a link to the entire policy.  Any employee, vendor, or contractor who has questions regarding Hunterdon Healthcare System’s policies regarding the False Claims Act or other compliance issues should contact the Corporate Compliance Officer for Hunterdon Healthcare System, who can be reached directly at (908) 237-7059.

THE FEDERAL FALSE CLAIMS ACT
CIVIL False Claims Act; 31 U.S.C.  3729-3733
The False Claims Act (FCA) is a federal law, which imposes civil liability on organizations and individuals for knowingly submitting to the federal government a false or fraudulent claim for payment.  It applies to all federal programs, from military procurement contracts to welfare benefits to health care benefits.

The False Claims Act prohibits, among other things:

• Knowingly presenting or causing to be presented to the federal government a false or fraudulent claim for payment or approval;
• Knowingly making or using, or causing to be made or used, a false record or statement in order to have a false or fraudulent claim paid or approved by the government;
• Conspiring to defraud the government by getting a false or fraudulent claim allowed or paid; and
• Knowingly making or using, or causing to be made or used, a false record or statement to conceal, avoid or decrease an obligation to pay or transmit money or property to the government.

A person or entity found liable under the Civil False Claims Act is subject to a civil money penalty of between $5,500 and $11,000 plus three times the amount of damages that the government sustained because of the illegal act.  In health care cases, the amount of damaged sustained is the amount paid for each false claim that is filed.

THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986
31 U.S.C., 3801-3812
The Program Fraud Civil Remedies Act of 1986 (PFCRA) authorizes federal agencies such as the Department of Health and Human Services (“HHS”) to investigate and assess penalties for the submission of false claims to the agency.  The conduct prohibited by the PFCRA is similar to that prohibited by the False Claims Act.

A violation of this section of the PFCRA is punishable by a $5,000 civil penalty for each wrongfully filed claim, plus an assessment of twice the amount of any unlawful claim that has been paid.

NEW JERSEY HEALTH CARE CLAIMS FRAUD ACT
The New Jersey Code of Criminal Justice Title 2C:21-4.2
On January 15, 1998, the new crime of “health care claims fraud” was established under the New Jersey Health Care Claims Fraud Act.  The NJ Health Care Claims Fraud Act is intended to enable more effective criminal prosecution of individuals who knowingly or recklessly submit false or fraudulent claims for payment of health care services.

PROTECTION FOR WHISTLEBLOWERS
The FCA permits a person with knowledge of fraud against the United States Government to file a lawsuit on behalf of the government against the business that committed the fraud, know as a qui tam action or whistleblower.

Anyone initiating a qui tam case may not be discriminated or retaliated against in any manner by their employer.  The employee is authorized under the FCA to initiate court proceedings to make themselves whole for any job related losses resulted from any such discrimination or retaliation.

 8 page PDF format (65KB)
Corporate Compliance Program - Deficit Reduction Act of 2005 

For more information about Hunterdon's Corporate Compliance Program contact Darlene Mitchell, Corporate Compliance Officer, via e-mail or telephone at (908) 237-7059.