Med-Net Compliance
Where Healthcare Compliance and Ethics, Education, Risk Management/Safety, Quality Assurance Performance Improvement (QAPI), and Law come together to to ensure regulatory compliance.
The Med-Net Compliance and Ethics Program facilitates the identification, evaluation, mitigation, and abatement of risk exposures related to healthcare fraud, waste, abuse, privacy, and data security. The Program meets the requirements of the Department of Justice, Department of Health & Human Services Office of Inspector General (OIG), Centers for Medicare & Medicaid Services (CMS), state departments of health, and Medicaid Fraud Control Units (MFCUs).
Med-Net Compliance, LLC strives to enhance the integrity of our clients’ compliance and ethics program by detecting and preventing healthcare fraud, waste, and abuse as defined by Medicare and Medicaid regulations.
Our goal is to facilitate and support efforts to satisfy statutory and regulatory requirements as enforced by federal and state authorities, reducing potential fines, penalties, and closure.
An effective Compliance and Ethics Program includes seven elements:
- Element 1: Standards, Policies, and Procedures
- Element 2: Compliance Program Administration
- Element 3: Screening and Evaluation of Employees, Physicians,Vendors, and Other Agents
- Element 4: Communication, Education, and Training on Compliance Issues
- Element 5: Monitoring, Auditing, and Internal Reporting Systems
- Element 6: Counseling and Discipline for Noncompliance
- Element 7: Investigations and Remedial Measures
Program Benefits
Med-Net Compliance, LLC has the expertise to serve as your safety net and partner in managing your compliance and ethics risk exposures.
Adhere to all applicable Patient Protection and Affordable Care Act, Department of Health & Human Services Office of Inspector General, and Centers for Medicare & Medicaid Services rules and regulations related to avoiding fraud, waste, and abuse, and protecting resident/patient privacy and data security.
Achieve the proper documentation of care and services to support billing, coding, and claims submissions.
Prevent, promptly detect, and take appropriate corrective actions to address and prevent compliance and ethics exposures.
Use data analytics to identify, address, and mitigate risk exposures.
Compliance & Ethics Exposures
- Fraud, Waste, and Abuse
- Enforcement Agencies: Department of Health and Human Services Office of Inspector General and State Fraud Unit and Office of Civil Rights
- Patient Protection and Affordable Care Act (PPACA)
- False Claims Act
- Anti-Kickback Statute
- Physician Self-Referral Law
- Deficit Reduction Act of 2005
- Exclusion Authorities
- Civil Monetary Penalties Law
- Patient Privacy and Data Security
- Health Insurance Portability and Accountability Act (HIPAA)
- Health Information Technology for Economic and Clinical Health Act (HITECH)
