Compliance

Purpose of the Corporate Compliance Program

The Corporate Compliance Program was developed to assist in establishing a culture within SIH that promotes the prevention, detection, and resolution of instances of conduct that do not conform to federal and state law; federal, state, and private payer health care program requirements; or SIH’s ethical and business policies. One of the objectives of the Corporate Compliance Program is to reduce the potential for fraud and abuse by:

  • Providing additional oversight of SIH’s compliance with laws, regulations, and special conditions imposed upon it by licensing and regulatory authorities
  • Identifying and preventing compliance violations and unethical conduct
  • Identifying and avoiding transactions or business practices which might result in irregularities in payment or reimbursement
  • Minimizing the loss to the government from false claims, thereby reducing the facility’s exposure to civil damages and penalties, criminal sanctions, and administrative remedies, such as exclusion from the Medicare and/or Medicaid programs
  • Encouraging employees to report potential compliance violations
  • Improving operations
  • Supporting SIH’s commitment to provide quality patient care

Laws & Topics Covered by SIH’s Corporate Compliance Program

SIH’s Corporate Compliance Program has an emphasis on fraud and abuse in the Medicare and Medicaid programs; however, the Program also includes compliance with virtually every law and regulation that applies to SIH. The scope of topics covered by SIH’s Corporate Compliance Program includes, but is not limited to, the following:

  • Fraud and Abuse
  • Stark/Anti-kickback
  • Quality
  • Medicaid and other regulatory issues
  • Identity theft
  • Tax exempt status
  • Certification Standards
  • Proper collection practices
  • Health Information Portability and Accountability Act (HIPAA) Privacy and Security
  • Environmental Laws
  • Drug and narcotics issues
  • Emergency Medical Treatment and Active Labor Act (EMTALA)
  • Patient rights and consent
  • Protocols for new or experimental treatments
  • Institutional review board
  • Disposal of medical waste
  • Patient and employee safety
  • Americans with Disabilities Act
  • Anti-trust laws
  • Copyright law
  • Utilization management
  • Document retention and authentication
  • Human Resource Laws