Jefferson University Hospitals

Deficit Reduction Act (DRA)

The Deficit Reduction Act applies to employees, associates, vendors, providers and any other business partner of Thomas Jefferson University, d/b/a Jefferson Health, and its controlled affiliates.

Thomas Jefferson University, d/b/a Jefferson Health, and its controlled affiliates (collectively “Jefferson”) are committed to complying with the requirements of the Federal Deficit Reduction Act (DRA) of 2005 and to preventing and detecting fraud, waste, and abuse. The DRA requires Jefferson to establish written policies regarding compliance with the federal False Claims Act and certain other laws, which include whistleblower protections and procedures for detecting and protecting against fraud, waste and abuse, as a condition of receiving reimbursement from federal and state health care programs. 

False Claims Act (FCA)

As a recipient of federal health care program funds, including Medicare and Medicaid, Jefferson is required by law to include in its policies and provide to all employees, associates, agents and contractors, detailed information regarding the federal False Claims Act and applicable state civil and criminal laws intended to prevent and detect fraud, waste, and abuse in federal health care programs.

As an employee, associate, vendor, provider and any other business associate of Jefferson, you are required to adhere to Jefferson's Preventing Fraud, Waste and Abuse and the Federal False Claims Act Policy. Please ensure that all applicable personnel within your organization understand and agree to follow Jefferson’s Fraud Waste and Abuse Policy when engaging in activities related to their work with Jefferson.

Under the False Claims Act, it is a violation to knowingly submit a false claim to the federal government. 

Examples of health care fraud that could lead to the submission of false claims to the government are:

  • Falsifying billing or medical coding
  • Billing for goods or services not medically necessary
  • Duplicate billing for items or services
  • Submitting bills for services never performed or items never furnished
  • Failing to return overpayments

Jefferson’s Code of Conduct and Ethical Behavior emphasizes honesty and integrity.  All members of the Jefferson community, including vendors, associates and business partners, must comply with federal, state, and local laws and must exercise their duty to prevent fraud, waste and abuse at Jefferson.  Such duties include, but are not limited to, reporting all concerns and suspicions regarding instances of fraud, waste, abuse, or suspected false claims act violations to appropriate parties or authorities.

Jefferson maintains a corporate compliance program and strives to educate all members of the Jefferson community on fraud and abuse laws, including the importance of submitting accurate claims and reports to federal and state governmental authorities.  Anyone with knowledge of potential fraud, waste, or abuse must report such through any of the following methods:

Retaliation or retribution for reporting issues in good faith is prohibited at Jefferson.