CAU Healthcare Regulatory Compliance & Accreditation Programs Response Discussion

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Healthcare Regulatory Compliance and Accreditation APA Style Reply

Two components of a compliance Program Reply to each Peer about their post.

Two components of a compliance Program Reply 1 to Georgina:

Two components of an effective compliance program: I believe they are the most essential components for either a small suburban hospital and/or a large inner-city hospital complex that are:

• Conducting internal monitoring and auditing
• Responding appropriately to detected offenses and developing corrective action.

“To maintain its functionality and effectiveness, the compliance program must be continuously watched,” (Moseley, 2015). According to the Compliance Officer, they must have a monitored program operation combined with details to the Compliance Committee and senior management. When the company has an auditor to come and audit once a month. They have the ability to know if they stayed in compliance. Some other places similar to the urgent care (where I used to work), never had an auditor come and check if the rules and regulations been followed. There were so many wrongdoings among patient and staff even errors in medications use. Responding to detected offenses with corrective: actions is when performance is noticed that disrupts the hospital’s compliance program policies, federal or state laws and regulations, or payor program requirements prompt and appropriate corrective action is essential to protect the hospital’s reputation and legal status, (Moseley, 2015). Also, it helps to prevent sexual conduct between a patient and physician or medical staff member.

When considering federal sentencing guidelines, it is important to look at what are the consequences of actions and comparison other violation. You do not want to make two week or two strong of a penalty for actions that have been taken by the people involved. It is much like when I judge goes back in their chambers and research what has been the standards in the past for each specific crime that is being tried, they reference that and make a decision to assist in a practical and as fair as possible decision of punishment.

References

Moseley, G. B. (2015). Managing Legal Compliance in the Health Care Industry. Burlington: World Headquarters Jones & Bartlett Learning.

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Two components of a compliance Program Reply 2 Yanira:

Hello everyone,

To answer this week’s discussion regarding a compliance program that could be effective in a small suburban hospital or a large city complex. Why is it important to consider Federal Sentencing Guidelines when deciding compliance components? Compliance needs to be designed to fit the type of organization being run; it should be “custom” made to fit the organization, whether it’s a small or big company. Compliance is a policy that is written and is practiced through the organization. Training people on how to communicate with staff and clients, understanding the values of the ethics of compliance. To understand the components of compliance, running a small business medical organization should ensure the hospital or organization is not submitting any fraudulent claims to the insurance policies and improving the customer service that is offered to patients. According to Moseley, G. B. (2015), “The purpose of a compliance program and associated activities is to promote adherence to federal and state laws on fraud abuse and the program requirements of federal, state, and private health plans. They accomplish this by building a hospital organizational culture that encourages the prevention, detection, and correction of noncompliance events that violate federal and state law.” The organization must understand that everything should be submitted and truthful regarding patient care and services. Following these standards and types of ethical procedures for compliance should help the organization maintain open for business. This is why it is essential to follow the Federal Sentencing Guidelines when running a small or large company.

Reference:

• Moseley, G. B. (2015). Managing legal compliance in the health care industry. Burlington, MA: Jones & Bartlett Learning.