Question

Part C

As a healthcare manager, you may be called upon to develop a compliance plan for your healthcare organization. The office of inspector general suggests seven guiding principles/elements to be included in any compliance plan. These elements are presented in chapter 2 and reproduced below.

Designation of a compliance officer and a compliance committee

Development of compliance policies and procedures, including standard of conduct

Developing open lines of communication

Appropriate and education

Internal monitoring and auditing

Response to detected deficiencies

Enforcement of disciplinary standards

Review the attached sample compliance plan.

Point out examples and evidence from the sample compliance plan to show that it follows the seven principles outlined above. If you feel there is no evidence for one or more principles, indicate the same with justification.

Are there areas of improvement and changes that you would like to make to this sample compliance plan.

If you were appointed as the Compliance Coordinator (whose responsibilities are outlines in the sample compliance plan), what are some of the top-priority tasks you need to complete in order improve compliance at your organization (one example includes arriving at an educational program for employees/coders).

Note: Questions 2 and 3 are open-ended and subject to interpretation, and there is no single correct answer.

Suggested number of words for part C: 800 words.

Answer 1

If I was appointed as the Compliance Coordinator with responsibilities to outline the sample compliance plan. I would have included some of the priority tasks to complete, in order improve compliance at our organization with the aid of 7 fundamental elements.
An effective compliance plan must be crucial for preventing fraudulent claims and erroneous billing, preparing for potential audits, and avoiding ethical conflicts in business operations and patient care services. Considering these all factor with respect to compliance of plan i would include some written policies, procedures, and standards of conduct. To achieve these goals will comply with these code ogmf conduct as follows
The Seven Fundamental Elements of an Effective Compliance Program
Element One: Implementing Written Policies, Procedures, and Standards
of Conduct
Element Two: Designating a Compliance Officer and Compliance
Element Three: Using Due Diligence in the Delegation of Authority
Element Four: Educating Employees and Developing Effective Lines of Communication.
Element Five: Conducting Internal Monitoring and Auditin.
Element Six: Enforcing Standards Through Well-Publicized Disciplinary Guidelines.
Element Seven: Responding Promptly to Detected Offenses and Undertaking Corrective Action. with regard to compliance
Additionally, if noncompliance with the law results in an HHS-OIG complaint and investigation, the consequences can be significant. Merely not understanding the law or failing to provide compliance training for staff usually is not a sufficient excuse for violations.