Quality of the estimate. December, p. 47 - Health Care Compliance ...

More documents

Recommendations

Info

Soar to higher levels of compliance and risk management . . . When you’re forced to rely on labor-intensive spreadsheets, point solutions, or a software system retrofitted to the health care industry, it can feel as if your risk is managing you. Go beyond risk management to continuous improvement with a customized, scalable and complete solution, fully supported by experts in the health care compliance industry. Created exclusively for the health care industry, MediRegs ® ComplyTrack from Wolters Kluwer Law & Business provides you with the tools you need to proactively assess, understand, communicate and mitigate risk across your entire enterprise. ComplyTrack delivers industry-leading solutions for: ■ Compliance ■ Risk ■ Internal Audit ■ Privacy & Security ■ Audit & Compliance Committee ■ Legal ■ Health Information Management Visit MediRegs.com/ERM and learn why customers prefer our solution for enterprise compliance and risk management. HCCA ComplyTrack ad 7-11.indd 1 5/9/2011 11:09:20 AM
People on the Move Former Medicaid Inspector General James Sheehan joins New York City HRA as Chief Integrity Officer Former New York State Medicaid Inspector General and Associate U.S. Attorney for the Eastern District of Pennsylvania James Sheehan recently joined the New York City Human Resources Administration (HRA) as the agency’s Chief Integrity Officer. Mr. Sheehan will report directly to the Commissioner on anything related to agency and program integrity. Mr. Sheehan will have direct oversight of the Investigation, Revenue and Enforcement Administration (IREA) and the Office of Audit Services. Mr. Sheehan plans to use his experience with Medicaid integrity to build on the HRA’s past record of cost avoidance and recoveries from fraud investigations – in 2010, the Agency’s efforts led to a combined recovery and cost savings amount of more than $225 million—and focus on the further reduction of abuse, waste and fraud in New York City’s largest social services programs. “After serving the leading federal and state government agencies in prosecuting fraud and protecting program integrity, I am honored to work for the greatest city in the world and the largest municipal social services agency in the country,” said James Sheehan, HRA Chief Integrity Officer. “My job will be to ensure the protection of public dollars by continuing the Agency’s excellent record in investigating and vigorously prosecuting individuals caught engaging in fraud or other illegal activities, and developing new data mining and analytic techniques to identify risk areas and prevent fraud.” HHS-OIG team honored On October 18, 2011, the HHS-OIG’s Health Care Reform Technical Assistance Team received the Glenn/Roth Exemplary Service Award in recognition of the team’s expert technical assistance to Congress throughout the health care reform legislative drafting process. This award was presented at the 14th annual Inspector General Community Awards ceremony. VA appoints new Chief Compliance and Business Integrity Officer The Veterans Health Administration recently announced the appointment of Robert Criscuolo as the new Chief Compliance and Business Integrity (CBI) Officer. Criscuolo will serve as the principal advisor to the Undersecretary of Health in matters relating to compliance and organizational integrity in the business arena. Health Care Compliance Association • 888-580-8373 • www.hcca-info.org Omnicare appoints Kathleen McGuan Chief Compliance Officer Recently Omnicare, Inc. announced Kathleen McGuan was appointed Senior Vice President and Chief Compliance Officer. Ms. McGuan will oversee and lead Omnicare’s corporate compliance function. In this role, she will be a key contributor as the company continues to reinforce its commitment on compliance. Ms. McGuan will report directly to Omnicare’s Board of Directors and John Figueroa, Omnicare’s Chief Executive Officer. Welmont Health System appoints Nolan Senior VP of Assurance and Compliance Robert Nolan, a veteran leader in the health care compliance field, has been named Senior Vice President of Assurance and Compliance Services at Wellmont Health System. n Received a promotion Have a new hire in your department If you have received a promotion, award, or degree; accepted a new position; or added a new staff member to your compliance department, please let us know. It’s a great way to let the Compliance community know where you have moved on to, or who has joined the Compliance team. Send your job change information to: service@hcca-info.org. December 2011 23
Page 1 and 2: Volume Thirteen Number Twelve Decem
Page 3 and 4: INSIDE 5 The rising tide: Recognizi
Page 5 and 6: The rising tide: Recognizing your c
Page 7 and 8: Legal function of any consulting ar
Page 9 and 10: side and show that proper actions w
Page 11 and 12: If you disagree with the requested
Page 13 and 14: n Starting from Scratch o I just re
Page 15 and 16: CFO was particularly timely in ligh
Page 17 and 18: territory in the early years. The m
Page 19 and 20: Social Networking John Falcetano Ed
Page 21: y the federal and state agencies th
Page 25 and 26: may find themselves in a netherworl
Page 27 and 28: Losing sleep over health care marke
Page 29 and 30: Editor’s note: Jeffrey N. Joyce i
Page 31 and 32: The first domain for establishing r
Page 33 and 34: for research services provided by p
Page 35 and 36: Community Relations. A process to r
Page 37 and 38: With the implementation of the EMR
Page 39 and 40: showed that the company viewed its
Page 41 and 42: Healthcare facilities that are seri
Page 43 and 44: CCB The Compliance Professional’s
Page 45 and 46: Legislators viewed the Medicare RAC
Page 47 and 48: Confidence and precision in claims
Page 49 and 50: universe is no less than $9,650. No
Page 51 and 52: Accountability is the key to compli
Page 53 and 54: Accountability is the key to compli
Page 55 and 56: Regulatory compliance for research
Page 57 and 58: Occupational Fraud and Abuse, it is
Page 59 and 60: offenses, including modification of
Page 61 and 62: n Control environment The control e
Page 63 and 64: organization is complying with regu
Page 65 and 66: Publisher: Health Care Compliance A
Page 67 and 68: esearch Compliance Conference June
Page 69 and 70: eimbursement and the growing separa
Page 71 and 72: even a decrease in physician paymen
Page 73 and 74:
New HCCA Members Alabama n Patricia
Page 75 and 76:
What could you do with The Power of
show all

Quality of the estimate. December, p. 47 - Health Care Compliance ...

Create successful ePaper yourself

Delete template?

Save as template?