The Compliance Officers Handbook Strategies And Tools For A Comprehensive Healthcare Compliance Program

The Compliance Officer's Handbook, Third Edition, gives compliance officers everything they need to take charge of a healthcare compliance program, whether they are new to the field or seasoned professionals who want to incorporate the latest strategies. Packed with legal insights from two experts on the latest OIG regulations, this handbook delivers tools, practical examples, and interpretations to build and maintain programs consistent with best practices for risk assessment, HIPAA compliance, training, monitoring, and auditing for compliance, and a host of other organizational responsibilities. ... The new edition includes: A new, in-depth chapter interpreting HIPAA regulations, including compliance with the authorization and notification requirements related to the privacy, security, and breach notification rules. A comprehensive chapter detailing critical issues for the compliance officer: establishing, monitoring, and documenting fair market value and commercial reasonableness between referral sources to avoid violating the Stark Law and Anti-Kickback Statute, or the False Claims Act. The following new forms: Income Guarantee Monthly Report, Community Need Checklist, Employment Justification Analysis Form, and Non-Monetary Benefit Tracking Form.

The tools and information you need to lead a comprehensive compliance program. This revised edition is packed with even more practical tools, case studies, tips and tools, sample audits, and sample policies and procedures to help you construct a comprehensive program and meet new regulatory and industry requirements. All of these tools and strategies have been created, tested, and proven by professionals in the field.

Ready-made compliance policies and procedures that you can adapt to your facility. Policies and procedures are the backbone of any compliance program. Compliance professionals must ensure that their policies and procedures are effective and up to date. To ensure effectiveness, the OIG expects hospitals to regularly re-evaluate their policies and procedures. Insight from a former Inspector General The Healthcare Compliance Professional's Guide to Policies and Procedures is written by former Inspector General Richard P. Kusserow. He has filled this book with sample policies and procedures that hospitals can use to strengthen their existing compliance program or help build a new one. Customize your program immediately The Healthcare Compliance Professional's Guide to Policies and Procedures provides the easy-to-use policies and procedures you need to ensure that your compliance program runs efficiently and smoothly. With these tools you will be able to: Implement proven, effective policies and procedures by using the sample templates provided Instruct staff with easy-to-comprehend instructions regarding policy and procedure development Identify best practices for policy and procedure development that are most likely to pass OIG investigation Ensure your policies are up to date with all legislation passed through the beginning of 2008 All of these sample policies and procedures can be used right away. Download our sample policies directly from the companion CD-ROM. You can then customize each document to fit your specific situation. It's that easy to develop a proven, effective set of policies and procedures! Take a look at the table of contents to see the variety of sample policies and procedures you will receive with The Healthcare Compliance Professional's Guide to Policies and Procedures: Compliance program oversight policies and procedures Compliance officer duties and responsibilities Confidentiality agreements Compliance officer and legal counsel protocol Records management Standards of conduct Ethics Compliance education and training Billing and coding policies Accurate coding Observation status Accurate documentation Prohibition of fraudulent and abusive billing Medicare's "incident to" rule Charity/uninsured care Medical necessity How to check for medical necessity ABN use for items and services that do not meet medical necessity Conflicts of interest agreements Gifts Vendor relationships Discounts/professional courtesies Reporting compliance problems Hotline use Hotline auditing Responses to complaints Nonretaliation policy (whistleblower protection) Auditing and monitoring Procedures for documenting auditing and monitoring Standards for auditing and monitoring Policies specific to laws and regulations Stark Anti-kickback statute False Claims Act Deficit Reduction Act EMTALA HIPAA Other risk areas Quality of care Clinical trials

Thomas Fox, the Compliance Evangelist, is one of the leading writers, thinkers and commentators on the nuts and bolts of compliance. His always practical advice is now available in one volume, The Complete Compliance Handbook. This book incorporates the most recent pronouncements and guidance from the Department of Justice, including 2017's Evaluation of Corporate Compliance Programs and FCPA Corporate Enforcement Policy, to provide the most up-to-date advice on what constitutes a best practices compliance program. In this single volume compendium, Fox brings together the tops ideas, topics and techniques you can incorporate your compliance program, literally in 31-days to more fully operationalize your compliance regime. If you want one volume to guide you in operationalizing compliance, this is it. The book is designed to provide you with a step-by-step guide to the design, creation, implementation of or enhancement to a compliance program. It begins with 31-days to a more effective compliance program. Each entry presents one thing you can accomplish, at little to no cost, to improve any level of compliance program. There are three key-takeaways for each entry. The final chapter goes through the same process for you to operationalize your compliance program. In between these bookends, The Complete Compliance Handbook features chapters on: -Operationalizing Compliance Through Human Resources -The Role of the Board of Directors and Compliance -360-Degrees of Communication in Compliance -Better Third-Party Risk Management -Reporting and Investigations -Internal Controls -Innovation in Compliance -Written Standards -More Effective Compliance for Business Ventures -Continuous Improvement The author, Thomas Fox, has written 15 books on compliance, leadership and business ethics. He founded the Compliance Podcast Network and has one of the largest social media presences in compliance. He has worked in the compliance arena for over 10 years and draws upon his many years of experience in the profession to create this single volume which will become the standard 'nuts and bolts' text on compliance. Fox's writing style is suited for any skill level of compliance practitioner or maturity of corporate compliance program.

The Health Care Compliance Professional's Manual is one of the most vital, long-standing, and best known resources in the world of health care compliance. It has all the tools you and your compliance team need to plan and execute a customized compliance program. This new edition is filled with industry best practices, sample forms, policies, procedures, and much more to save you time and comply with federal standards. The Health Care Compliance Professional's Manual will help you to: Use OIG publications and Federal Sentencing Guidelines to plan and execute a customized compliance strategy that meets tough federal standards and minimizes enforcement risks Oversee physician compensation and referrals Perform risk assessments using matrixes with step-by-step instructions to pinpoint areas that pose compliance and operational risks Draft compliance policies that form the foundation for a strong compliance program Build a strong infrastructure reinforced by industry best practices Create an effective education and training program that instills in employees the importance of legal compliance Implement a privacy and security plan that ensures patient information is protected Stay up-to-date on the latest legal and state and federal regulatory requirements affecting your facility, in areas such as HIPAA, EMTALA, fraud and abuse, reimbursement, privacy, security, patient safety, and clinical research Study for CCB(R) Certification in Healthcare Compliance (CHC) Packed with tools to make your job easier and more efficient, The Health Care Compliance Professional's Manual will provide: Practical coverage of federal and state laws governing your facility Insight into helpful federal standards on effective compliance programs Step-by-step guidance on implementing a sound compliance program Examples of common risk areas and how to handle them Time savings and peace of mind from sample policies, checklists and forms from members of the American Health Law Association (AHLA) The Health Care Compliance Professional's Manual will help you protect your company if violations do occur: Learn how to apply auditing, monitoring, and self-assessment techniques for conducting internal investigations Discover how to successfully follow the OIG's voluntary disclosure program to resolve overpayment problems and avoid exclusion from Medicare Find out how to enter into a corporate integrity agreement to settle with the federal government and mitigate FCA-related penalties Document your compliance efforts so you leave a protective paper trail that shields you from liability And much more Previous Edition: Health Care Compliance Professional's Manual, Second Edition ISBN: 9781543813265 SKU: 10071961-7777

Written for virtually every professional and leader in the health care field, as well as students who are preparing for careers in health services delivery, this book presents a framework for developing a patient safety program, shows how best to examine events that do occur, and reveals how to ensure that appropriate corrective and preventative actions are reviewed for effectiveness. The book covers a comprehensive selection of topics including The link between patient safety and legal and regulatory compliance The role of accreditation and standard-setting organizations in patient safety Failure modes and effect analysis Voluntary and regulatory oversight of medical error Evidence-based outcomes and standards of care Creation and preservation of reports, data, and device evidence in medical error situations Claims management when dealing with patient safety events Full disclosure Patient safety in human research Managing confidentiality in the face of litigation Managing patient safety compliance through accountability-based credentialing for health care professionals Planning for the future

This book delivers tools, practical examples, and interpretations to build and maintain programs consistent with best practices for risk assessment, HIPAA compliance, training, monitoring, and auditing for compliance, and a host of other organizational responsibilities.