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Aug 10, 2021 · Compliance programs are mandatory in healthcare; the Affordable Care Act (ACA) Section 6401 states that every "provider of medical or other items or services… shall establish a compliance program as a condition for enrollment in Medicare, Medicaid, or the Children's Health Insurance Program" (CHIP).
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The purpose of healthcare compliance is to assist with the prevention of erroneous healthcare claims submission to healthcare insurance carriers (federal, state, and commercial). The ultimate goal is to prevent fraud, waste, and abuse .
The GCPG provides information about relevant Federal laws, compliance program infrastructure, OIG resources, and other information useful to understanding health care compliance. The GCPG is voluntary guidance that discusses general compliance risks and compliance programs.
Apr 6, 2022 · This article provides a high-level summary of healthcare compliance programs in the United States, including who is required to have a compliance program, the seven core requirements of a compliance program, and the risks of not having a compliance program.
OIG's compliance documents include special fraud alerts, advisory bulletins, podcasts, videos, brochures, and papers providing guidance on compliance with Federal health care program standards.
Aug 21, 2023 · Corporate compliance in healthcare organizations plays a central role in ensuring patient safety and upholding ethical standards. With an effective corporate compliance program, transparency is enhanced, fraud is reduced, and trust is built with patients and regulatory bodies alike.
Corporate compliance ensures that healthcare organizations not only adhere to the many layers of regulations but also craft an environment of safety and trust for patients and professionals alike. Dive with us as we explore the complexities and necessities of compliance in the healthcare sector.
Jul 1, 2004 · Guidance that addresses the roles of the in-house corporate general counsel and an organization's chief compliance officer in supporting the compliance oversight function of health care organization governing boards.
This Hub page includes AHLA resources on all aspects of health care compliance, which offer both a foundation for understanding the complex regulatory environment and for staying abreast of new and evolving requirements.
Whether it’s through avoiding penalties, minimizing litigation, or preventing costly errors, an optimized compliance program can translate to substantial savings for a healthcare facility, ensuring that resources are channeled towards patient care rather than paying for preventable missteps.
