Which of the following is a recommended first step if you suspect fraud or abuse?

• A. Immediately stop submitting any problematic bills
• B. Contact the compliance officer in the facility if there is one
• C. Seek knowledgeable legal counsel
• D. Disentangle yourself from the problematic relationship

Answer: (B)

Reporting to the facility's compliance officer is the recommended first step when you suspect fraud or abuse because the compliance program is designed to handle concerns through a formal, confidential process. The compliance officer can guide the investigation, ensure proper documentation, protect you from retaliation, and coordinate with leadership, legal, and any external regulators as needed. Following this channel helps preserve evidence and ensures actions taken are lawful and policy-aligned.

Acting on your own to stop submitting bills can disrupt records and potentially violate rules or laws, which is why it’s not the right first move. Seeking legal counsel is important, but typically comes after engaging internal compliance to determine whether external guidance is necessary. Disconnecting from a problematic relationship doesn’t address the issue through the proper channels and may leave the problem unresolved.