MCO Compliance and Audit Plan For Homecare

A formal compliance program, as an additional element in this process, offers a home health agency a further concrete method that may improve quality of care and reduce waste. Compliance programs also provide a central coordinating mechanism for furnishing and disseminating information and guidance on applicable Federal and State statutes, regulations, and other requirements. Implementing an effective compliance program requires a substantial commitment of time, energy, and resources by senior management and the home health agency’s governing body. Superficial programs that simply purport to comply with the elements discussed and described in this guidance or programs that are hastily constructed and implemented without appropriate ongoing monitoring will likely be ineffective and could expose the home health agency to greater liability than no program at all. While it may require significant additional resources or reallocation of existing resources to implement an effective compliance program, the OIG believes that the long term benefits of implementing the program outweigh the costs

7 Elements Of A Legally Effective Compliance Program

1- Policies & Procedures.

2-Chief Compliance Officer/Compliance Committee.

3-Education & Training.

4-Reporting.

5-Monitoring & Auditing.

6-Enforcement.

7-Responding To Issues.