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In: Operations Management

Compliance officers are found in virtually all health care organizations. Most hospitals have a dedicated compliance...

Compliance officers are found in virtually all health care organizations. Most hospitals have a dedicated compliance officer. Smaller organizations may designate one of the top administrative leaders as the organization’s compliance officer. Health plans also have compliance officers. Any organization that bills Medicare or Medicaid needs a compliance officer.

You will be interviewing a compliance officer for a health care organization and using that information to write a paper. The list of potential paper topics is:

Upcoding services delivered to increase reimbursement to the organization

Accepting vacations or gifts from a vendor such as a pharmaceutical sales person in exchange for buying that vendor’s products

HIPAA compliance audits for the use of personal electronic devices

Treating patients after a professional license has lapsed

Not reporting medication errors

Keeping these topics in mind, the questions you will need to ask when interviewing the compliance officer are:

What are your roles and responsibilities as the compliance officer?

What are the methods used for a patient to file a complaint?

How do you deal with civil versus criminal complaints?

What moves an internal compliance issue to have to be reported to law enforcement, CMS, or a health plan?

What are the most risk management issues for your organization?

What type of accreditation issues do you work on?

For this discussion, you will come up with additional questions to help you write your paper.

In your first post, list an additional three to five questions that you will plan to ask the compliance officer that you will interview. Focus on the roles of a compliance officer and what the compliance officer sees as possible trends in the future for that role. Review the HCCA website to view current resources about health care compliance issues.

Solutions

Expert Solution

  • What are the prospects for a larger number of male compliance officers in their early 40s?
  • How can healthcare compliance be achieved in organizations where the compliance officer not a part of the senior management, and, does not have a contract. This is the case for nearly 50% of the organizations? Is compliance better in organizations with compliance officer as a part of the senior management, even though more than 60% report to the CEO, or, the President?
  • The salary for the compliance officer is higher than the salary for the attorneys. The projected salary increase is only 3 to 5%. Is this seen as an attractive career option?
  • How have the transformational factors such as heightened expectation for swift management, and, heightened compliance risk changed the manner in which healthcare compliance is undertaken?
  • How have the proliferation of private to private compliance obligations and evidentiary privilege affected compliance?
  • How have the provisions of the Government resolution agreements defined the state of the art in compliance practice?

keosha answered 1 year ago
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