Introduction
Healthcare compliance refers to adhering to all statutory, administrative, and social adherence norms in the healthcare sector to offer patients excellent treatment services. The purpose of healthcare internal control guidelines is to help the individual practitioner and organized numbers of clinicians create a complying initiative that promotes conformity to laws and rules that apply to the government healthcare system (Teitelbaum & Wilensky, 2016).
In addition, it is aimed at preventing the impact of clandestine financial dealings among healthcare professionals and facilities on choices about medical assistance. These healthcare compliance programs can also benefit medical practices by contributing to the standardization of administrative procedures. An example of a statutory requiring conformity in the healthcare industry is Anti-kickback.
Discussion
The anti-kickback statute forbids trading anything of monetary value to encourage payment or the referral of patients eligible for compensation under government health care services. Examples of unlawful kickbacks include accepting cash benefits on suggestions, acquiring free office structures, and obtaining high salaries for healthcare board positions (Weinstein, 2020). Also, in the past, healthcare experts would award patients for visiting their hospitals by giving them a small present. This act was a horrible idea because the client would only care about the gesture of gratitude and not the service level. Additionally, health providers tended to send patients to their facilities to get many clients for their selfish interests. The anti-kickback prevents all these acts by imposing strict rules and penalties on those healthcare practitioners, including being removed from the Medicare system business.
Regulatory compliance refers to the combination of practices and procedures that facilitate an institution’s compliance with regulations, guidelines, and other laws in place where the organization functions. Regulations are put in place to ensure organizations follow the rules and stick to the moral standards that are relevant to their work to protect society. Though several medical centers may see regulations as a roadblock to performance, a facility may have a competitive advantage if it operates effectively to conform to regulations. One regulation in the compliance of the function health institutions is the children’s healthcare insurance program.
CHIP is a system designed by the United States Health and Human Department Services that funded equivalent grants to assist families who have children get healthcare coverage (Adams et al., 2019). The program was created to provide coverage for unregistered kids in households with moderate incomes that are too high to be eligible for Medicaid. This is because children are very delicate; hence they are prone to the contraction of diseases. The Human Service and Health Department ensures that health institutions comply with the set rules.
In order to comply with the legal requirements, Healthcare organizations must conduct frequent internal audits and inspections to determine if the healthcare system is complying with the set rules. In addition, the organization must put into operation compliance and practice requirements. Appoint a compliance officer who will make sure that healthcare adheres to the set laws. In addition, health organizations must also provide adequate training to their staff members so they cannot violate the law. Furthermore, the institution must develop suitable responses to recognized violations and necessary changes and create open communication channels. Finally, the organization must enforce disciplinary norms through widely disseminated rules.
Conclusion
The Office of the Inspector General (OIG) is the biggest general office in the federal government, which takes action against medical professionals who violate Medicaid rules or endanger the welfare and health of Medicaid beneficiaries. The OIG also establishes rules to respond immediately to complaints. This will contribute to improving the services offered to patients in healthcare facilities. The OIG also ensures that everyone is aware of their responsibilities and that of the administration of the medical facilities.
References
Adams, E. K., Johnston, E. M., Guy, G., Joski, P., & Ketsche, P. (2019). Children’s health insurance program expansions: What works for families?Global Pediatric Health, 6(234). Web.
Teitelbaum, J. B., & Wilensky, S. E. (2016). Essentials of health policy and law. In Google Books. Jones & Bartlett Publishers.
Weinstein, M. L. (2020). Stark Law and anti-kickback statute modernization, why now?Clinical Gastroenterology and Hepatology, 240(4). Web.