Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Regulating Health Care
Lecture:The Role of Medical Records in U.S. Health Care
Slide content:OIG Compliance Program Tips - 1 The Seven Fundamental Elements of an Effective Compliance Program Implementing written policies, procedures and standards of conduct Designating a compliance officer and compliance committee Conducting effective training and education. Developing effective lines of communication 11
Slide notes:Compliance programs have been a focus of health care organizations since the late 1990s, when the U.S. Office of the Inspector General, or OIG, began a campaign against fraud and abuse in health care for the Medicare and Medicaid programs. The fight against fraud and abuse has escalated in the past few years. Those who report fraudulent practices, called whistleblowers, are protected. The issues of fraud and abuse are complicated. Compliance programs within health care organizations broadly focus on all external rules, regulations, laws, accreditation guidelines, internal medical staff bylaws, and department compliance responsibilities. The location of the compliance program depends on the organization. For example, it may operate under a separate department, within risk management, or in the quality department. The Office of the Inspector General provides training on compliance issues. There are seven fundamental elements of an effective compliance program. Four are shown here and there are three on the next slide. 11