hcp513 | Graduate
Health Care Compliance Foundations
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Introduction to Health Care Compliance
- Differentiate between laws and regulations.
- Identify federal and state regulatory agencies that monitor organizations and enforce laws.
- Explain the purpose of and need for compliance.
- Identify common organizational structures and types of health care organizations.
Role of the Compliance Officer
- Explain the role and responsibilities of a compliance officer.
- Explain the role and responsibilities of a compliance committee.
Compliance Plans and Programs
- Identify types of health care facilities and compliance plans.
- Explain basic elements of a compliance program.
- Explain how regulatory and oversight agencies monitor and enforce compliance plans and programs.
Federal Acts, Enforcement, and Penalties
- Compare and contrast oversight and enforcement.
- Identify federal acts that have an impact on health care.
- Explain the penalties incurred for violating federal acts.
Accreditation and Professional Licensing
- Explain the need for professional licensing and scope of practice.
- Explain the role of compliance in the accreditation process.
- Explain federal exclusion list requirements.
Financial Relationships Auditing
- Explain the risks of financial relationships between hospitals, physicians, and referral sources.
- Analyze the reasons for creating a database to track financial relationships.
- Explain how an effective compliance program can defend against scrutiny and investigation.
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