to check out our website Scan with your smartphone Train your employees with the help of Freddy FraudBuster. He will navigate your employees through interactive training modules that cover important policies and requirements of Fraud, Waste & Abuse and HIPAA Compliance. Pay by check City______________________________ State______ Zip______________ Billing Address________________________________________________ Cardholder's Name ___________________________________________ Exp. _________________ Card Security Code ______________________ Card No._____________________________________________________ Bill my card Payment: Send Payment to: PAAS National® 160 Business Park Circle Stoughton, WI 53589 Fax: 608-873-4009 Check Enclosed in the Amount of: $_____________________________ WEBSITE Cell Phone* ____________________________________________________ NCPDP#* ______________________ NPI#*_________________________ Phone* _____________________ Fax Number* ______________________ Address*______________________________________________________ Email Address*__________________________________________________ Pharmacy*_____________________________________________________ Contact Name*__________________________________________________ *Following information to be provided in *RED is REQUIRED* *A PAAS National® FWAC/HIPAA Program Membership entitles a pharmacy up to 20 employees. FWAC/HIPAA Program* –Take control of FWA and HIPAA today! Pharmacy owners are the center of the PAAS National® CUSTOMIZED – Tailored policies, procedures and forms to fit your store’s needs. Implement what you have created. COMPLETE – Everything that you need for FWA and HIPAA compliance all rolled into one convenient package. EASY – Access your store’s account anytime, 24/7, and know instantly what steps you need to take toward completion. • Pharmacies failing to meet HIPAA requirements could be assessed fines up to $1.5 million per type of violation. • Violations have caused pharmacies and pharmacists to lose their licenses, and face criminal charges and incarceration. • One pharmacy cited for FWA Non-Compliance was required to submit to unannounced, onsite audits on a quarterly basis for two years – and pay the audit costs! • V iolations have resulted in pharmacies being expelled from participation in Medicaid and Medicare Part B and D. • A New York pharmacy self-disclosed to the OIG and agreed to pay $164,842.50 for allegedly employing an individual that it knew or should have known was excluded. • T here are many ways to be excluded including a previous contract dispute with the U.S. Postal Service. Employing individuals on either the OIG or GSA Exclusion Lists can result in minimum penalties of $10,000 and up to three times the amount of claims. ALL pharmacies are contractually required to have a comprehensive compliance program. – Avoid fines, penalties, audit problems and worse with the PAAS FWAC/HIPAA Program!