Compliance
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A Compliance Program is described as a commitment by the organization’s top management to ensure that the organization plays by the rules. Compliance, in its simplest form, is the act of meeting the expectations of others. In the healthcare industry, including that of healthcare research, compliance means meeting the expectations of those who regulate our business, pay our claims and grant us money. We accomplish this by abiding by applicable legal requirements, including deterring and detecting violations of the laws, regulations and policies that help to regulate the healthcare industry.
For healthcare organizations, such as UMMC, compliance programs focus on compliance with fraud and abuse laws, such as the Civil False Claims Act, the Federal Anti-kickback Statue, Health Insurance Portability and Accountability Act, the Physician Self-Referral Law (“STARK”), federal and state requirements related to research, and requirements of federal and state sponsored health plans and other third-party payers.
UMMC’s compliance efforts establishes a culture that promotes the prevention, detection and resolution of conduct that noncompliant. As part of that effort, UMMC has established a means for UMMC Workforce, as defined under the UMMC Compliance Plan, and the public at large, to report, in good faith, suspected noncompliance. Such reports can be made anonymously and UMMC will, to the greatest extent possible, preserve the anonymity of the reporter. A reporter may utilize one of the methods listed below to report suspected noncompliance.