Compliance
Compliance Helpline: 800.965.4583 or 618.529.2540
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 payor health care program requirements; or SIH’s Code of Ethics and internal 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 improper 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 safe, 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 every law, requirement, contractual 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)
- 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
- Protocols for new or experimental treatment/research
- Document integrity, retention and authentication
- Finance and Accounting
- Credentialing
- Equal employment opportunity
- Insurance and other licensure issues
- Medicare contractor and Shared Savings Program requirements
- Physician hospital organization requirements
- Wage and hour requirements
- Workplace violence