Care Management Compliance Guidance & Support

The Centers for Medicare and Medicaid services has issued rules and regulations for providing patients with Care Management services. The OIG’s Compliance Program Guidance documents provide a critical framework for developing and implementing an effective Compliance Program. Vector Consulting has in-depth knowledge of current guidelines and regulations from both the clinical and law perspective.

Health care organizations are drawing intense scrutiny from not only the government but also from patients for high-quality care and compliance with health care rules and regulates. With the enactment of the Patient Protection Affordable Care Act (PPACA), transition to the International Classifications of Diseases, Tenth Revisions (ICD-10), and government increase enforcement activities, among other initiatives, health care organizations must seek strategic solutions to manage compliance and risks. If your organization is found to be non-compliant, the fines, penalties, restitution, and reputation damage can be staggering. We have found that the internal audit function plays a vital role in the organization’s compliance with the everchanging regulations environment. Internal audit employs a systematic, consistent, standard-based, disciplined approach to their work; and brings expertise and understanding to systems of internal controls that protect against the impact of non-compliance. The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has stated that ongoing auditing of high risk areas is a critical factor in any effective compliance program. Internal auditing can and should play a meaningful role in this regard.

For more information on our care management and healthcare compliance solutions, please contact us at (888) 843-1575 or fill out our online contact form. One of our consultants will speak with you about how to best address gaps in your program.

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