What Important Factors Should Be Part Of An Effective Compliance Program?

Who is responsible for compliance in an organization?

Corporate compliance creates and executes the organization’s corporate compliance program relative to its role.

Management and all members of the organization are responsible for ensuring that compliance with laws, rules and regulations occurs..

How do you report a compliance issue?

To report a compliance issue, you may contact SCAN in one of these ways:SCAN Hotline at EthicsPoint: (877) 863-3362 or visit www.ethicspoint.com.Contact SCAN’s Compliance Officer: Andrew Whitelock. 3800 Kilroy Airport Way, Ste. 100. Long Beach, CA 90806. ComplianceOfficer@scanhealthplan.com.

What are high risk areas for compliance issues?

Following are four of the most common risks and the best methods to minimize their impact and, ideally, avoid them: Identity Theft Via the Electronic Medical Records in the Healthcare Industry. Credit Card Fraud in the Payment Card Industry. European Union Consumers’ Confidential Information.

How do you create an effective compliance program?

Elements an Effective Compliance ProgramEstablish and adopt written policies, procedures, and standards of conduct. … Create program oversight. … Provide staff training and education. … Establish two-way communication at all levels. … Implement a monitoring and auditing system. … Enforce consistent discipline.More items…•

What are the three main parts of a compliance policy?

Compliance auditing/monitoring reports, trends and corrective action plans. Summaries of incidents, as well as self-reporting and disclosures. Evidence that recurring issues are being addressed and compliance standards are being enforced.

What are the five key functions of a compliance department?

A compliance department typically has five areas of responsibility—identification, prevention, monitoring and detection, resolution, and advisory. A compliance department identifies risks that an organization faces and advises on how to avoid or address them.

What is one result of an effective compliance program?

The purpose of compliance programs is to promote organizational adherence to applicable federal and state law, and private payer healthcare requirements. An effective compliance program can help protect practices against fraud, abuse, waste, and other potential liability areas.

What does a compliance plan look like?

Simply put, a compliance plan is a system of checks and balances through which a reasonable effort is made to identify potential non-compliance issues regarding applicable laws and regulations, and to eliminate or mitigate those issues. Basically: find it, fix it, and follow it to make sure the issue is fixed.

What is the objective of compliance?

OBJECTIVE – the overriding objectives of a compliance officer should be to ensure that an organization has systems of internal control that adequately measure and manage the risks that it faces.

What are the 7 elements of compliance?

Seven Elements of an Effective Compliance ProgramImplementing written policies and procedures. … Designating a compliance officer and compliance committee. … Conducting effective training and education. … Developing effective lines of communication. … Conducting internal monitoring and auditing. … Responding promptly to detected problems and undertaking corrective action.

What makes a great compliance officer?

A compliance officer must therefore have great people skills and be able to communicate and cooperate up, down, and across the employee chain – and must simultaneously have a firm grasp of the business. … Ethical and principled: These are the single most important qualities of a compliance manager.

What are the benefits of compliance?

Silver Linings: 10 Business Benefits of Your Compliance ProgramReduces organizational and individual risk. … Enables less hesitance and more confidence. … Uncovers better data for better decisions. … Gives the gift of efficiencies and economies of scale. … Results in a smaller, better organized toolbox. … Levels the playing field. … Helps realize a company’s mission.More items…•

What aspects should a compliance plan cover?

The 7 Elements of a Compliance Program Are as Follows:Implementing written policies, procedures, and standards of conduct.Designating a compliance officer and compliance committee.Conducting effective training and education.Developing effective lines of communication.Conducting internal monitoring and auditing.More items…•

What is effective compliance?

Establishing an effective Compliance and Ethics Program (“Program”) has become a necessity to protect any highly regulated organization. At its core, an effective Program protects an organization by detecting and preventing improper conduct and promoting adherence to the organization’s legal and ethical obligations.

What are examples of issues that can be reported to a compliance department?

Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper Management only. These are examples of issues that can be reported to a Compliance Department: suspected Fraud, Waste and Abuse (FWA); potential health privacy violation, and unethical behavior/employee misconduct.

What is the most important element of a compliance program?

Operating in accordance with applicable laws and regulations. Creating a culture of honesty and integrity. Meeting high ethical and professional standards. Preventing fraud and abuse and other compliance issues.

What will the scope of a compliance program depend on?

The scope of a compliance program will depend on the size and resources of the physician practice. … Physician practice management companies also may serve as a source of compliance program guidance. The OIG Work PlanEach year, in October, the OIG releases a work plan outlining its priorities for the fiscal year ahead.

Why is it important to have a compliance program?

Enforcing compliance helps your company prevent and detect violations of rules, which protects your organization from fines and lawsuits. The compliance process should be ongoing. Many organizations establish a program to consistently and accurately govern their compliance policies over time.

How many cores are needed for an effective compliance program?

seven core requirementsOrganizations must create and maintain compliance programs that, at a minimum, meet the seven core requirements. An effective compliance program fosters a culture of compliance. To help ensure compliance, behave ethically and follow your organization’s Standards of Conduct.