Knight Medical Compliance Plan Essay

Article 8 gives examples on using the AICPA Code of Professional Conduct. The article gives the example of you taking over the role of handling the independence and ethical matters involved with auditing for a retiring partner in your firm. You are quickly given the task of determining whether or not your firm can provide auditing services to a client that owns a small, privately owned bank and a used car dealership. To perform work for the client you want to see the rules on how the firms will remain independent from the bank and car dealership, and you have a week to research any questions or concerns that you have with the potential client.

The Office of Inspector General (OIG) has established a set of guidelines (e.g., auditing, monitoring, internal controls, sampling, due diligence, and standards of organizational and employee behavior, etc. Page 508 of the textbook) that physician practices should follow when creating a compliance plan. State an opinion as to which OIG guideline would be the single most significant aspect of a compliance plan for a small practice. Provide a rationale for your response.

The purpose of this assignment is to review the factual content of and critically reflect upon the legal compliance considerations of eight major areas including, the Joint Commission, HIPAA/HITECH, Health Finances, Revenue Cycles, Medicare Recovery Audit Contractors, OIG work plan, OIG Corporate Integrity Agreement (CIA), the False Claims Act, and compliance and Provider Self Disclosure Protocol. These key elements have been provided by the GRC software Compliance 360 webpage.

Patient safety has always been an area of interest to me ever since I started to have an interest in the health care field. I think that patients are what keep organizations operating for years and years. Patients are our customers. Without them nurses, doctors, therapists, dieticians, nutritionists, to name a few, would be without a job. An organization needs to do everything possible to keep patients safe and reduce error. For example, if a patient goes to a hospital to get treatment and the staff keep making mistake after mistake then that patient isn 't going to want to return and will probably tell all his friends and family to not go to that hospital, which will result in a loss for the hospital and will probably have a bad

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 standardized healthcare industry rules and regulations for the safe and secure transmission of medical information. The Department of Health and Human Services has responsibility for HIPAA controls.

Jeff has over 20 years in the compliance field. As a former Deputy United States Marshal and Special Agent, he has conducted healthcare investigations regarding a myriad of providers and payors. Jeff has testified in federal courts and state superior courts as well as numerous regulatory proceedings. Jeff possesses a great deal of experience in the design and implementation of compliance and HIPAA programs.

A broad example of ethically based laws is presented in the compliance training for the Harris County Hospital District. (#9). Each law is listed in groups by category, although they are not covered in detail. Certainly, a supplemental section would be useful integrate examples of these laws as they apply to daily job functions. It is important to realize how integral this integration to a fast paced, high stress position in healthcare, especially clinical. Surprisingly, Garner Health Law Firm (#11)

In the health care system there are many laws and regulations that are put into place to protect the patients that use the health care system as well as the facilities and insurance companies. Unfortunately in some cases physicians, facilities and employees break these laws and cause a critical problem in the system. In the case of Park Ridge Hospital and Adventist Health Systems, Park Ridge Hospital was found guilty of insurance fraud and over charging patients. These fraudulent charges and procedures not only cost the patients money but also have a huge impact on health care all together.

The OIG working through the DHHS attempts to guarantee that secured elements act inside the bounds of protection and security laws set up in HIPAA and related federal healthcare legislation. One of the OIG’s principle obligations is respect to the medical billing and coding industry is the avoidance of deceitful movement among secured elements. As a restorative charging and coding authority you should be cautious about potential action that might be fraudulent by the OIG.

Healthcare fraud is costly for everybody, as it harms the reputation of the institution or physician committing it, and financially damages the patient being affected.By definition fraud may be defined as intentionally employing surprise, trickery, cunning, deception and unfair ways by which one party cheats another party out of financial resources. In order to educate a healthcare manager regarding fraud , many aspects of fraud must be assessed. This includes the types of fraud, the consequences that come with fraud,the individual(s) committing them, techniques to prevent fraud, and why the healthcare industry is vulnerable to fraud.

Having an effective ethics and compliance in health care training course for employees within a company is a positive effort to keep not only the company running strong and efficient, but also developing standards for other companies to follow who are trying to create a more applicable format for corporate regulations. According to federal guidelines, designated and regulated by the Office of Inspector General (OIG), a company in compliance to federal healthcare standards will have effective education of employees, investigation measures, discipline and enforcement measures, intervention of violation standards, strong internal audit standards, compliance officers and staff, and lastly, written company standards and policies that is freely available to all employees.

Healthcare providers already done their very best to manage the patients’ medical problems yet patients’ compliances will affect greatly on the success. Medication adherences are closely related to patients’ perceptions towards asthma and inhaled corticosteroid. They can be categorized into asthma deniers, asthma accepters, and pragmatics. Each category differs much from one to another in terms of their beliefs towards asthma and the use of medication. For example, patients who are concerned about corticosteroids may reduce or discontinue the medication for long term. Misconceptions towards the side effect may also influence the patients’ compliances for asthma therapy.

Background: Parkland Memorial Hospital is located in Dallas, TX; it is the biggest county hospital in the state. The hospital was cited many times for ethical violations; consequently, it was under federal and state investigation for Medicare and Medicaid (CMS) fraud, substandard patient care, and safety problems. In May 2013, the hospital entered into a five year corporate integrity agreement (CIA) with the Office of Inspector General of the U.S. Department of Health and Human Services (OIG) to correct its ethical violations and patient safety problems.

Ethics by definition states that it’s the study of morality. Ethics are the basis of our criminal justice system. From the arresting officers who take an oath to serve and protect, to the attorneys and courts, we assume the behavior and rules are ethically and morally sound. We as the public should think we are in good hands when it comes to the Criminal Justice System. I think we should have people in the system with good morals and great values. We want to be assured that our laws and those enforcing them are supported.

The AICPA Code of Professional Conduct, regardless of its numerous strengths, the Code of Professional Conduct has some serious weaknesses. The accounting profession is constantly changing and making improvements. The first weakness in the Code of Professional Conduct deals with conflictions within the code due to the code being constantly updated (Dienhart, 1995). Dienhart, Lunday, and Tavani have all criticized professional codes because the directives cause conflictions with one another, whether it is direct or indirect. Rule 301 and SAS No. 99 are examples when the code is having conflicting standards. Rule 301, Client Confidential Information, states that professionals shall not