Please provide me a case study that includesCorporate compliance, risk management, and quality management from the website that i have attached. https://psnet.ahrq.gov/webmm-case-studies
Corporate Compliance
In Healthcare
What Is Corporate Compliance?
? A way for a company to
ensure that it is following the
laws and regulations that
apply to the goods and
services that its supplying.
What types of Organizations have a
compliance program?
• Home Healthcare
• Physician Group Medical Practices
• Hospitals
• Hospice
• Inpatient Rehab
• And more
Corporate Compliance & the Essential Elements of a
compliance program
Leadership
• Senior leadership is committed to compliance and sets the tone for the organization
Risk Assessment
• Designed to provide a big picture of your overall compliance program and helps you identify areas of high risks and conducted
annually. Ongoing process to help mitigate any risk that are a threat to your organization.
Standards and Controls
• Develop programs to set boundaries within the organization.
• Code of Conduct
• Policies and Procedures
• Operate on Best Practices
Training and Communication
• Annual training program administered to staff annually
Oversight
• Also question whether or not staff are following the compliance program.
• Monitoring- identifies gaps and is a commitment
• Auditing- targets a specific business component for review
You think a violation has occurred.
You ask yourself “What do I do”
As a healthcare worker:
? Know the following:
? Where to find the organizations policies and
procedures
? Healthcare Laws that protect Fraud and
Abuse
? Your Risk Manager, Ethics & Compliance
Officer, & Privacy Officer
? How to file a complaint by using the
Compliance Hotline which makes you
anonymous or contact one of the above
officials
Office of the Inspector General
OIG
Office of Inspector General (OIG)
Who is the Office of Inspector General?
? Federal program for Fraud and Abuse
? Mission: To protect the integrity of HHS programs as well as the health and welfare of program
beneficiaries (OIG, 2020)
Established in 1976
Forefront of the USÂ’s efforts to fight waste, fraud, and abuse in Medicare, Medicaid
and HHS programs
What is HHS?
? Federal program that fosters advances in medicine, public health, and social services.
OIG. (2020, JANUARY 2). COMPARISON OF THE ANTI-KICKBACK STATUTE AND STARK LAW. RETRIEVED FROM HTTP://OIG.HHS.GOV/COMPLIANCE/PROVIDER-COMPLIANCETRAINING/FILES/STARKANDAKSCHARTHANDOUT508.PDF
Office of Inspector General (OIG)
Conducts audits, investigations, evaluations and policy recommendations for decision makers
and the public.
OIG develops and distributes resources to assist the health care industry in its efforts to comply
with the Nation’s fraud and abuse laws and to educate the public about fraudulent schemes so
they can protect themselves and report suspicious activities.
Fraud increases the cost of healthcare and can harm Medicare and Medicaid patients.
Visit the website: https://oig.hhs.gov/
Fraud and Abuse – 3 Components
