If you detect a deficiency in your hospital that could result in a compliance issue, it is important to act quickly, fix the problem, and ensure employees understand the rules. Ask yourself these questions if you detect an issue:
- Has the hospital created a response team, consisting of representatives from the compliance, audit, and any other relevant functional areas, which may be able to evaluate any detected deficiencies quickly?
- Are all matter thoroughly and promptly investigated?
- Are corrective action plans developed that take into account the root causes of each potential violation?
- Are periodic reviews of problem areas conducted to verify that the corrective action that was implemented successfully eliminated existing deficiencies?
- When a detected deficiency results in an identified overpayment to the hospital, are overpayments promptly reported and repaid to the fiscal intermediary (FI)?
- If a matter results in a probable violation o flaw, does the hospital promptly disclose the matter to the appropriate law enforcement agency?
This tip is adapted from The Compliance Program Effectiveness Handbook. For more information about the book or to order your copy, visit HCMarketplace.
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