Corporate Compliance Program
The Corporate Compliance Program is an internally developed, selfgoverning
program that promotes ethical and legal business practices. It is
designed to prevent, detect, correct and, if necessary, report noncompliant
or illegal activities to the appropriate Federal and State authorities.
Purpose of the Corporate Compliance Program
This Corporate Compliance Program has been 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 payor 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; and
- Supporting SIH’s commitment to provide quality patient care.
Laws and 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 state regulations
- 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)
- Insurance and other licensure issues
- Wage and hour requirements
- Medicare contractor requirements
- Patient rights and consent
- Protocols for new or experimental treatments
- Credentialing
- Institutional review board
- Disposal of medical waste
- Patient and employee safety
- Sexual harassment
- Patient rights and consent
- Americans with Disabilities Act
- Anti-trust laws
- Finance and Accounting
- Copyright law
- Equal employment opportunity
- Utilization management
- SIH policies and procedures
- Document retention and authentication
- Referrals