Which of the following are reportable issues to Compliance Department?

• A. Only Fraud
• B. Potential health privacy violations
• C. Unethical behavior only
• D. Any of these issues, including suspected Fraud, Waste, and Abuse; health privacy violations; and unethical behavior

Answer: (D)

Reporting to Compliance covers a broad range of concerns, not just a single category. Any of these issues should be reported: suspected fraud, waste, and abuse; potential health privacy violations; and unethical behavior. Each area signals potential noncompliance with laws, regulations, or internal policies and can create financial, legal, or reputational risk. Fraud, waste, and abuse can involve improper billing or misrepresentation; health privacy violations involve unauthorized access to or disclosure of protected health information, which can trigger penalties and erode patient trust; unethical behavior undermines integrity and may indicate broader policy breaches. A Compliance Department is responsible for identifying and addressing all of these risks, so reporting any such concerns enables timely investigation, corrective action, and preventive measures. All of these categories are reportable to Compliance.