Hsa 546 Week 4

Medical directors of the physician groups will be responsible for ensuring education and compliance of staff to the policy.

The benefits and drawbacks of having state health programs verses one that is uniform across the country can vary on a broad basis. Medicare and Medicaid are state and federally funded health programs; programs that must be fair and allow access to everyone across the country that are enrolled and eligible to receive such benefits. In addition, these programs have unlimited caps so that there is flexibility to continue financing care without delay. The Medicare program was designed to provide access to health care for those who are not able to afford appropriate health care and meet the needs of vulnerable communities. If it were not for the assistance of the federal government in providing states the necessary funds to continue providing health

Practice: review, plan and monitor, eg respect for the value base of care, professional interactions with

The federal government is involved in all parts of health care at the national, state, and local levels. They have public

Health care professional, patients, families, and policy makers all struggle to understand how health is affected by behavior, economic and social structure and provided the knowledge to improve the health status of individuals and populations. Our health is affected by behaviors, economics, and social structure. Many behaviors and lifestyle patterns affect our health, such as: exposure to violence, vehicular accidents, alcohol, drugs, and infectious agents (Williams/Torrens). According to our textbook (Williams/Torrens), alcohol, tobacco and illicit drug use creates several of problems that affect our health and society.

The healthcare sector of the federal government covers programs for senior citizens, people with disabilities through Medicare, two thirds of the cost of joint state-federal Medicaid programs, which provides health reimbursement services for low income persons and families, and includes healthcare services for a variety of populaces including active duty and retired military personnel among others.

To assist in the prevention of errors, abuse and fraud in healthcare, the Federal OIG (the Office of Inspector General) and Medicare respectively publish the Compliance Program Guidance for Individual and Small Group Physician Practices and the Medicare Carrier’s Manual. In order to stay in federal compliance and prevent errors or worse, is it beneficial to be familiar with these documents. In a large company, while the Medical Office Specialist is the person that must be familiar to with the Medicare website this person is also the designated Compliance Officer and is responsible for providing the information on rules and guidance to the coders. To contact your medical office specialist, please refer to the company website or phone directory for your division. Remember, the federal government is not forgiving on errors when your response is ‘I don’t know’.

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.

Outsourcing Compliance, especially in a small hospital setting, may be the best way to be in compliance with required regulations and apply limited resources. Why do many healthcare organizations still not have a formal corporate compliance program, or do not have what would be considered an effective program? Lack of resources is often mentioned. Outsourcing compliance may be the answer. A corporate compliance program must address many issues, not just what is popularly discussed in the news media, such as HIPAA breaches. Outsourcing compliance, and providing privacy officer functions via a third party, may well work best for a smaller hospital.

In the US, a portion of medical services is taken care of by employers as well as by individuals. Moreover, the government has developed programs such as Medicare that cater for both disabled and elderly supported by federal funds (Blahous, 2015). Further, the state and federal funds help support Medicaid that caters for individuals with low income. The Affordable Care Act declares that individuals should not be denied health cover due to their pre-existing health conditions (Elhauge, 2015). It also forbids the insurance companies from dropping people with the

Patients, as consumers have a say on the decisions a healthcare facility makes regarding integrating CAM practitioners in their clinical practices. As such, a specialty clinic’s Chief Medical Officer should pay attention to the consumer suggestions. The patient should know that they will be granted the right to make health care decisions that resonate with their preferences, wishes, and values. Additionally, a patient would want to know whether the practitioners would respect their autonomy, regarding treatment decisions and health care goals, and act in patients’ best interests, according to fiduciary duties.

In the case of study “Missed Opportunity” there is a character by the name of Susan Daniels. Ms. Davis is the top marketing officer of Briarwood Medical Center, there she is trying to secure to billboards located on the premises. This is a prize location because the billboards panels are located on the main traffic strip. The panels will provide countless opportunities to market the medical center and an excellent investment. Briarwood Medical Center was entangled in a endless battle for the market share against a skilled competitor Crestview Hospital, thus making every opportunity to win patients crucial. This is an opportunity

Provide advice and recommendations to minimize risk and enhance Piedmont Healthcare compliance with required laws and regulations.

guidelines stated that registrants should practice safely and efficiently within their scope of practice, practice within the legal and ethical boundaries and understand all requirements set out by the HCPC. ODPs must maintain a good and safe practice environment with the understanding of the impact of human factors during peri-operative setting (HCPC, 2014)

The WHO definition of compliance is “the extent to which the patient follows medical instructions” . However, the term “medical” is felt to be insufficient in describing the range of