Camcare health corporation corporate compliance program
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CAMcare Health Corporation Corporate Compliance Program. Corporate Compliance. Purpose: To establish a system of internal controls designed to ensure that we regularly evaluate and monitor our own adherence to applicable statues, regulations and program requirements.

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Camcare health corporation corporate compliance program

CAMcare Health CorporationCorporate Compliance Program


Corporate compliance
Corporate Compliance

  • Purpose:

    • To establish a system of internal controls designed to ensure that we regularly evaluate and monitor our own adherence to applicable statues, regulations and program requirements


High risk areas for health centers
High Risk Areas for Health Centers

  • Billing and Coding

  • Grants Management

  • Internal Controls

  • Information Management

  • Tax Issues

  • Cost Reporting and Regulatory Filings


Elements of effective ccp
Elements of Effective CCP

  • Designate Corporate Compliance Officer and Committee

  • Develop and Implementation of Compliance & Practice Standards

  • Conduct Training & Education

  • Establish open lines of communication

  • Conduct Internal Monitoring and Auditing

  • Establish Process for Responding to Potential Offenses

  • Establish Disciplinary Standards


Corporate compliance committee
Corporate Compliance Committee

  • Corporate Compliance Officer

  • Medical Director

  • Nursing Director

  • Billing Director

  • Finance Director

  • MIS Director


Implementation of compliance practice standards
Implementation of Compliance & Practice Standards

  • Establishment of policy to promote compliance

    • Develop written policies and procedures that establish guiding principles or courses of action for staff

    • Policies and procedures must be consistent with the requirements and standards established by health center’s BOT and all regulatory and accrediting organizations


Training and education
Training and Education

  • Develop and provide ongoing education and training for BOT and Staff regarding the Compliance Program

    • All BOT and Staff will receive a General Compliance training

    • Specialized training for staff (ie. Staff with direct responsibility for coding and billing)

    • Focused training for areas identified in an audit to be potentially problematic


Open lines of communication
Open Lines of Communication

  • Establish a toll free hotline for reporting issues and concerns relating to compliance

  • Ensure that the telephone number is publicized in a common staff work area (ie. Break room, lunchroom)


Internal auditing and monitoring
Internal Auditing and Monitoring

  • Conduct periodic self audits to assure

    • Written standards and policies are in compliance with the law

    • Operating in compliance with written policies and procedures

    • Coding and billing are accurate with services provided

    • Documentation is accurate and complete

    • Furnished services are reasonable and necessary


Response to detected offenses
Response to Detected Offenses

  • Upon receiving a report of suspected non-compliance, the Compliance Officer will initiate steps to investigate the conduct in question

    • Interviews of persons with knowledge of the matter

    • Review of relevant documents and applicable laws

    • Engage legal counsel, external auditors, or health care experts to assist in the investigation if necessary


Establish disciplinary standards
Establish Disciplinary Standards

  • Establish and publish procedures for enforcing and disciplining individuals who violate the law

  • Disciplinary guidelines should be well publicized

    • Trainings

    • Policy and Procedure

    • Employee job descriptions

    • Employee handbook

    • Standards of Conduct


Why corporate compliance
Why Corporate Compliance?

  • Mandatory

  • Establishes a program to identify and respond to organizational risks

  • Identifies and addresses gaps in existing practices,policies and procedures

  • Program will deter potential fraudulent activity


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