|
THE COMPLIANCE LAW FIRM: A Division of Lippe & Associates in Dallas, Texas, provides legal advice and assistance to health care providers in dealing with problems concerning non-compliance with applicable regulations. In these situations, CMS usually demands the concerned provider to promulgate and implement a corrective action plan (CAP).
Handling CAP
Our firm can help you respond to this urgent demand. We will provide you guidance and consultation in drafting and submitting a compliance plan to be submitted preferably before the given deadline, so CMS can guide you on the required details. The drafting and implementation of CAP requires:
|
 |
• Immediate Responsiveness
• Intense Review of the Areas Highlighted by CMS
• Coordination among Numerous Departments
within the Company |
• Cooperative Efforts to Identify the Problem
Causes and Appropriate Corrective Actions
• Drafting and Submission of CAP |
• Negotiations with Regulators
• Follow through to Ensure the Proper and Effective
Implementation of the Plan |
Program
CMS requires adopting and implementing policies and procedures to provide for internal auditing and control to reduce fraud, abuse, and waste (Fraud, Waste, and Abuse Control Program). We help you ready this program or review the one you established to check if it covers the required areas of CMS.
Program Monitoring
The Medicare compliance officer and the Medicare compliance committee develop, operate, and monitor the Fraud, Waste, and Abuse Program. Therefore, coordination with the MCO and the MCC is integral to this process. A fraud, waste, and abuse control program is necessary because it is:
• Integral to Controlling the Costs of Providing Services and Profitability,
• Fundamental to the Retention of Authority to Continue as an Approved Provider under the Medicare Advantage Program
• A Function Specifically Included in the Responsibilities of the Medicare Compliance Officer and the Medicare Oversight Compliance Committee
• Crucial to Avoiding Potential Criminal Liability for Submission of False Fraudulent Claims
• Significant to Good Business Practice and Profitability for the Insurer
|
