Your health care organization has had several small compliance incidents in the past two years, and the organization is now motivated to update their compliance program. Your executive leadership team asked you to review two health care compliance programs from similar organizations to determine how they constructed their compliance program and what aspects your organization should adopt.

Select the type of health care organization you want represented in this assignment (e.g., family practice, hospital, urgent care, or nursing home).

Locate two compliance program documents from comparable health care organizations using your Internet search engine.

Read both compliance program documents and examine the similarities and differences between the two.

Create a matrix that compares how both organizations execute the following compliance components:

• How internal monitoring and auditing is conducted
• How compliance and practice standards are implemented
• The designated compliance officer (or person designated to be the contact for compliance matters), who that person reports to, and their relationship to the organization’s governing board
• How employees are trained and educated to model compliant behaviors
• How violations or offenses are detected, reported, and corrected
• How lines of communication with employees is developed
• How disciplinary standards are enforced

Write a 525- to 700-word executive summary that informs your executive leadership about the matrix you created and offer your opinion as to which best practices the organization should adopt for its own compliance program.

Cite the 2 compliance program documents and any additional references that support your opinion (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality).

Format your assignment according to APA guidelines. Compliance Programs Essay Assignment

ADDITIONAL INFORMATION;

Healthcare compliance programs

Introduction

Medical programs exist to help patients and their families receive the care they need. In return, the government requires certain levels of care from these medical providers in order to protect both sides. Medical organizations must register their compliance programs with the government in order to ensure that these programs are up-to-date and have not been violated.

Overview

• What is a compliance program?

A healthcare compliance program is a set of processes and policies that ensure that all aspects of your organization’s performance are in accordance with the law. It includes both internal and external compliance activities, including:

• Auditing procedures, including audits performed by internal resources such as auditors or quality assurance professionals (QAPs).

• Training programs for employees on how to identify violations, report them appropriately, follow up on those reports and investigate them if necessary.

• Reviewing all legal documents related to patient care so that your business remains compliant with regulations such as HIPAA or FACTA (Fair Credit Reporting Act). If you hire outside contractors who do medical billing services for example, they must be trained too!

How it works

Compliance plans are designed to meet the needs of the organization, and they’re flexible enough to change as the organization changes. They should include a process for reporting issues and resolving them, along with an awareness of all applicable laws and regulations. Compliance plans should be reviewed regularly by management so that they can help keep your business on track with its legal obligations.

Coverage requirements

Healthcare organizations are required to provide coverage for employees and their dependents. They must also cover all services provided by the organization, including those provided at any location where the organization offers services. Coverage requirements also apply to activities performed by an individual within their employment role, such as travel on behalf of the healthcare provider or volunteering with community outreach programs.

Compliance obligations

Healthcare compliance programs are developed to help ensure that healthcare providers in the United States comply with the law. They include:

• Developing a compliance program. This involves developing policies and procedures for how your organization will follow all laws, regulations, policies and procedures relevant to healthcare industry standards. It also includes training employees on those standards so they can implement them in their work day-to-day activities (e.g., writing prescriptions).

• Keeping records of implementation of your compliance program so you can report noncompliance if necessary or simply keep track of what happened during this process over time as part of an annual audit cycle at any given point during its development stage; this provides valuable information about where there may be weaknesses within the organization’s overall efforts towards compliance – which helps identify opportunities for improvement without having wasted resources already invested into creating something new just because someone forgot about it before now!

Compliance violations

Violations of the healthcare compliance program include:

• Not following the rules of the compliance program. This can lead to fines, penalties and other sanctions.

• Failure to meet an obligation under a contract or agreement with an insurer or payer (including Medicare).

• Making false statements on an application for coverage or in applying for coverage; misrepresenting a material fact concerning income when applying for health insurance through Marketplace plans; misrepresenting any material fact related to benefits offered under your plan; failing to report changes in employment status as required by federal law; avoiding paying tax on income received from any source including wages earned while employed full-time at work outside your home country; falsifying medical records or documents related to medical care provided by doctors/nurses who are authorized workers under state laws governing their practice (this includes physicians working in hospitals); stealing drugs from another person’s medicine cabinet – this includes taking someone else’s prescription medication onto yourself without permission using an excuse such as taking them so you can avoid getting sick — these actions will not only cause harm but also may result into criminal charges if caught doing them

Benefits of compliance plans

Compliance programs can help to improve patient safety and reduce liability risk. They also improve employee morale, which in turn helps to improve the quality of care provided by your organization. Compliance plans also help to reduce costs and increase revenue by making sure that you’re following all applicable standards and legislation within your industry. And finally, a well-thought-out compliance program will help make your reputation as an ethical health care provider even stronger than it already is!

Patient rights under a compliance program

• Patients can report violations of their rights to the compliance program. This can be done in person or by telephone, email, fax or mail.

• Patients have the right to receive information about the program and its activities.

• If they believe that they have been harmed as a result of a violation of patient rights under this program, patients may file an appeal with [insert name].

• Patients have the right to know what steps are being taken by your organization in response to complaints filed against it (if any).

Healthcare organizations must register their compliance program with the government.

Healthcare organizations must register their compliance program with the government. This is required by law, so that you can be sure that your organization is in compliance with all applicable laws and regulations. Compliance programs help protect patients, consumers and the public by ensuring that healthcare organizations are following rules and policies regarding safety practices and patient care standards. Compliance programs also help protect healthcare organizations from fines or other penalties if they don’t comply with these regulations; this includes paying for fines assessed against them by state or federal agencies as well as lawsuits filed against them for failing to meet certain standards of care (e.g., HIPAA).

Conclusion

Healthcare organizations must register their compliance program with the government. This will help them know what is expected of them and how they can stay in compliance with state and federal laws. Healthcare providers must also make sure that patients are aware of their rights when it comes to receiving care, including the right not to disclose personal information about themselves or their health history without permission from the patient.