Corporate Compliance in Health Care – Governance Oversight Change is Needed
Corporate compliance could be in for some changes in 2016, based upon the events of 2015, forecasting increased self-policing, personal accountability for leaders, and physician arrangements as the top risk areas. The government is seeking major, if not radical, changes in compliance oversight, writes Don Quigley, retired Chief Legal Officer for an East Coast health system, on the blog of The Source.
“When health care providers commit or tolerate fraud and abuse in their delivery of services or billing for such services, the unfair and avoidable costs to the government, payors, and patients are enormous,” he says.
“All health systems and hospitals need compliance programs. The ACA-mandated CMS review of compliance currently under way will likely make them mandatory and the risks today do not justify delay. The more pertinent question is how organizations with existing programs need to review and revise them to be ‘effective,'” Quigley writes. “Governing boards have a variety of committee structures that have been effective; one model for compliance risk is not necessary.”
