Compliance Officer Response It is often recommended for (HCO)’s to have a corporate compliance plan to be more efficient, reduce errors, and not have small errors turn into large errors. As (OIG) it’s a necessary and fundamental need to incorporate a corporate compliance plan to have for staff and management to stay organized and lessen the chance of fraud, waste, and abuse in the company. Stated by, (Cleverly, Song, & Cleverly, 2011), it is effective only if it includes management support, effective communication, continuous monitoring, and individual accountability. All these aspects are a continual monitoring requirement as long the corporate compliance is in place for the duration. Responsible Corporate Officer Doctrine- Question 3: 10 minutes 3.) What important aspects do you find in the Responsible Corporate Officer Doctrine to be beneficial for the health care organization? Any changes to the (HCO) to be implemented with the use of the Doctrine? The critical aspects in the Responsible Corporate Officer Doctrine that are beneficial for the health care organization are in many ways. There are provisions that comprise the (RCO) and protect in making the health care organization aware in cases of severe punishment of liability. According to (Clark, 2012), the (RCO) it states that the doctrine has been aggressively used and applied by regulators and prosecutors against businessmen in various administrative, civil, and criminal procedures, and has been described as the
Effective healthcare organizations routinely monitor and audit compliance performance. The processes ensure that the organization complies with regulations and uncovers compliance risks.
When it comes to a compliance plan program it provider a proactive program that will ensures that you will have full compliance with all the applicable, policies, and the procedures, law and regulations. Compliance officer’s are responsibilities that this will be include in the development and it will also be in the implementation and a good management of this program for action and a designed to make sure that you would want to have3 a ethical behavior that would be in accordance with all the rules of the MUSC’s core values as to expressed in a mission statement and a cord of conduct. In these program it will endeavor to protect. One of the key element this program is the cultivation and to nurturing of an environment committed to the principle
This paper seeks to look into organizational behavior in health care management and most importantly its impact on health care management and delivery. Organization behavior is crucial in guiding the regulatory activities, the staff activities and the overall culture that directs an organization. Organizational behavior in health care setting is paramount to ensuring patient safety, ethical behavior among the medical practitioners, patient-centered care and effecting change in the facilities which is bound to improve healthcare delivery and patients’ satisfaction. The strategic management of any health
Therefore, the provisions of SOX has been very effective in regulating ethical behavior of healthcare organizations where under the threat of strict federal regulations and penalties that may lead to 20 years of imprisonment and million dollar fines, these organizations may not attempt to violate the regulations and will ensure ethical functioning around the organizational
Accountable Care Organizations (ACOs) are group of physicians, hospitals and other healthcare providers coming together voluntarily to deliver high quality healthcare to patients. On the other hand, American Hospital Association (2010) defines ACO as legally structured arrangements between hospitals, specialty physicians and/or primary care and other healthcare providers to facilitate effective and efficient healthcare for a defined patient population. Typically, ACO focuses on assisting patients with chronic disease to get right care at the right time with overall goals of preventing medical errors and unnecessary duplication of healthcare services. More importantly, ACO focuses on delivering high quality healthcare at low costs. The Health and Human Service (HHS) estimates that ACO could assist Medicare to save more than $960 Million in the first three years, which will assist Medicare to spend healthcare dollars more wisely. (Centers for Medicare & Medicaid Services.2012).
Dr. DoRight has recently been hired as the President of the "Universal Human Care Hospital", where he oversees all departments with over 5,000 employees and over 20,000 patients at the medical facility. Dr. DoRight discovers that some patients within the hospital have been dying as a result of a variety of illegal procedures by doctors and nurses, and negligent supervision and oversight on their part. After two years, there have been no results from the investigation and some patients are still passing away due to the negligent activities. In this research paper I will discuss what Dr. DoRight, of Universal Human Care Hospital will do when he discovers that patients within the hospital have been dying as a result of a variety of illegal procedures by doctors and nurses and negligent supervision and oversight on their part.
plan, the need for a plan for assuring legal, ethical and professional compliance, as well
In the present health services administrative environment, corporate compliance programs are a vital business capacity for recognizing hazard and staying away from obligation, particularly in light of the Government 's extended assets and expanded spotlight on indicting extortion and misuse. A corporate compliance program is a framework which is designed to recognize and avert infringement of law by the employees and employers of an organization. There are five basic elements that are used to produce an effective corporate compliance program, they include; leadership, risk assessment, standards and controls, training
According to Gary Trainor, “When it comes to a business and corporate management, compliance refers to the company obeying all of the legal laws and regulations in regards to how they manage the business, their staff, and their treatment towards their consumers. The concept of compliance is to make sure that corporations act responsibility.” (Trainor, 2012).
Duty of the Health Administrator is to make ethical and challenging decisions in order to help all staff members and parties involved. According to the article,” Ethics and the Image of the Healthcare Administrator in Popular Culture” Health care Administrators in some ways their actions can be more ethically impactful than those of physicians, as their decisions typically affect a broad population rather than a single patient at a time (Jones and Bartlett Publishers; pg.11:2011) For example, If a patient sues a hospital for medical negligence due to a physicians medical error, not only does the Health Administrator has to investigate the incident and try to find a feasible solution, he or she has to hold all parties involved accountable, while ensuring his or her decision is fair and ethically correct, because his or her decision will weigh heavily on the outcome of the negligence case. “Healthcare administrators need to make decisions that are not only fiscally sound but ethically sound as well with the prime stakeholders affected by their actions in mind”(Jones and Barlett Publishers; pg.11:2011). For Instance, if a Health Care Administrator wrongfully terminates an employee, the employee may take legal actions and this could cost the hospital and stakeholders a substantial amount of money and tarnish the hospitals reputation. Unlike, most roles in
The Co-Chief Compliance Officers ensure all Compliance Policies and Standard Operating Procedures are reviewed no less than annually. Such review is intended to allow necessary policy revisions to reflect changes in Impac’s operating philosophy, laws or regulations, business practices, product offerings, or other factors. All changes to the policy and program must be approved by the business unit leader and the Co-Chief Compliance
Compliance is a new and growing area within the healthcare field. Prior to 10 years ago, healthcare providers self-managed themselves in following rules and regulations in their practice but it was not defined as compliance. Now, compliance has evolved into programs and departments within healthcare facilities where they provide oversight to providers, ensuring they are following the rules while communicating with the CEO and the Board of issues that may arise. Compliance officers serve in an non-biased role in assessing non-compliant activity within departments, working with legal to resolve any issues surrounding government entities e.g. CMS, HHS, Medicaid, and communicate with staff to encourage reporting of non-compliant activity within the organization.
Per the CEO’s anticipated renewal of his contract, the CEO has provided this Office with data the CEO personally obtained concerning salaries of the CEOs of other hospitals in the area. The CEO has requested that he participate on the committee to determine his compensation package, and specifically to participate in determining his own fair market value. Both the data and the CEO’s request to be on the relevant committee are problematic. This Office recommends that the CEO’s requests be denied, and that alternative measures be taken.
The much anticipated Chief Compliance Officer (CCO) scrutiny in 2016 and possible enforcement action could spell changes for institutional investors, a report by Hazel Bradford of Pionline.com indicates. The changes are going to happen because institutional investors will be closely monitored by compliance experts. Compliance officer typically help organizations identifying risks and formulate response. Regulatory organizations such as the New York based Regulatory Fundamentals Group LLC, is determined to assist organizations to articulate their expectations and correct failures to meet the expectations.
Competent, ethical and methodic corporate leadership contributes immensely to the success of corporate business organizations in the 21st Century. The formulation of rules, regulations, and policies are essential in the governance of a corporation to mitigate and control any identifiable risk to the firm. These policies form the basis of key principals, which govern the routine operations of an enterprise. It is essential for corporate organizations to have clear guidelines that determine the processes and operations of a business venture not only ensure compliance, but to avoid larger issues of corporate fraud and unethical business practices. In this report, we will review QBE Insurance Group’s current governance protocols and practices and provide recommendations where deemed necessary by the author.