In many companies, the compliance officer is the first to become aware of a potential compliance problem that could lead to civil or criminal liability. A best practice is to give the compliance officer the authority to conduct internal investigations.
When voluntary disclosure for overpayments is an option rather than an obligation, the provider may encounter diverse opinions among its decision-makers. Some may express a desire to bring the potential problem to the attention of the government and attempt to resolve the matter quickly without incurring criminal penalties, civil fines, or exclusions.
The government is starting a trial program in the District of Columbia that aims to improve treatment for Medicaid beneficiaries struggling with serious mental illness or substance use disorders.
Frequent users of the emergency department are often also high users of other medical, social, and mental health services. This underscores the need for hospitals to address not only medical issues, but the behavioral health and social needs of patients, says a new analysis published in the November issue of Health Affairs.
