Complete Healthcare Compliance Manual 2022

The Health Care Compliance Professional's Manual gives you all the tools you need to plan and execute a customized compliance program that meets federal standards. It walks you through the entire process, start to finish, showing you how to draft compliance policies, build a strong compliance infrastructure in your organization, document your efforts, apply self-assessment techniques, create an effective education program, pinpoint areas of risk, conduct internal probes and much more. The Health Care Compliance Professional's Manual is used by the Health Care Compliance Association (HCCA) as the basic text for its Compliance Academy - the program that prepares compliance professionals for the CHC (Certificate in Healthcare Compliance) certification exam. The Health Care Compliance Professional's Manual will help you to: Use OIG publications and Federal Sentencing Guidelines to help plan and execute a customized compliance strategy that meets tough federal standards Perform risk assessment to pinpoint areas within your company that pose compliance and operational risks Draft compliance policies that form the foundation for a strong compliance program Build a strong infrastructure for compliance to work, including hiring the right personnel Create an effective education and training program that instills in employees the value of legal compliance Conduct internal probes that uncover legal violations before the federal government does - and mitigate possible penalties Stay up-to-date on all the latest legal and regulatory requirements affecting your facility, including HIPAA, EMTALA, fraud and abuse reimbursement, privacy, security, patient safety and much more! Packed with tools to make your job easier, The Health Care Compliance Professional's Manual will provide: Practical coverage of federal and state laws governing your facility Document efforts and apply self assessment techniques Insight into helpful federal standards on effective compliance programs Step-by-step guidance on implementing a sound compliance program Time-saving sample compliance policies, forms, checklists, and chart The Health Care Compliance Professional's Manual will protect your company if violations do occur: Learn how to apply auditing, monitoring, and self-assessment techniques 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

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 Environment of Care Compliance Manual, Fifth Edition Thomas J. Huser, MS, CHSP, CHEP The Environment of Care Compliance Manual, Fifth Edition, provides all the guidance safety officers need to comply with The Joint Commission's Environment of Care standards and corresponding CMS requirements. Author Thomas J. Huser, MS, CHSP, CHEP, discusses topics such as safety and security, hazardous materials and waste, fire prevention, medical equipment, life safety, utilities management, and management plans, delivering imperative information in a hassle-free format. This valuable resource also includes policies and procedures, forms, and tools that can be easily downloaded and customized to use at your organization. This book will provide readers with: Analysis and compliance tips for each EC standard and element of performance (EP) Explanation of changes to the interpretations and scoring of the standards and EPs Policies and procedures to comply with standards affecting all areas of the EC A look at how Joint Commission and CMS requirements overlap Strategies to avoid Joint Commission and CMS survey hot spots Evaluation procedures to validate your processes Forms and tools that can be customized for your facility Table of Contents Chapter 1: Strategies for the Environment of Care Chapter 2: Safety and Security Chapter 3: Hazardous Materials and Waste Chapter 4: Fire Prevention Chapter 5: Medical Equipment Chapter 6: Utilities Management Chapter 7: Functional Environment Chapter 8: Staff Competency Chapter 9: Demonstrating Implementation of Care Chapter 10: Updated Survey Hotspots

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