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1.3.3 Employee Education on False Claims Recovery
In accordance with the United States Code (USC), Title 42, §1396a(a)(68), and as a condition for receiving payments, any entity that receives or makes annual Medicaid payments of at least $5,000,000 shall establish written policies for all employees of the entity as well as all employees of any contractor or agent of the entity (including management) that provide detailed information about the following laws and their role in preventing and detecting waste, fraud, and abuse in federal health-care programs:
• The federal False Claims Act (31 USC §§3729-3733).
•Administrative remedies for false claims and statements as provided in Chapter 38 of Title 31, USC.
•Texas law relating to civil and criminal penalties for false claims (including Chapter 36 of the Human Resources Code; Section 35A.02 of the Penal Code; Title 1, Chapter 371, Subchapter G of the TAC; and other applicable law).
•Whistleblower protections under the above laws (including section 36.115 of the Human Resources Code).
The entity must also include, as part of the above written policies, detailed provisions regarding the policies and procedures of the entity for detecting and preventing fraud, waste, and abuse. In addition, the entity must also include in any employee handbook a specific discussion of the following:
•The above laws.
•The entity's policies and procedures for detecting and preventing fraud, waste, and abuse.
•The rights of employees to be protected as whistleblowers.
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