5111.101 Fraud, Waste and Abuse Prevention and
Detection
(A) "Federal Health Care Programs" has the same meaning as in 42
U.S.C. 1320a-7b(f).
(B) Each person and government entity that receives or makes
Medicaid payments in a calendar year that total five million
dollars or more shall, as a condition of receiving such payments,
do all of the following:
1. Provide each of the person or government entity's employees
(including management employees), contractors and agents, detailed
written information about their role in preventing and detecting
fraud, waste and abuse in federal health care programs.
2. Include in the written information provided, detailed
information about the person or government entity's policies and
procedures for preventing and detecting fraud, waste and abuse.
3. Include in the person or government entity's employee
handbook a specific discussion of the laws, the rights of employees
to be protected as whistleblowers, and the person or government
entity's policies and procedures for preventing and detecting
fraud, waste and abuse.
Ohio Health Plan's Procedures for Detecting
Fraud, Waste and Abuse