Managed care under siege: how an effective compliance program can protect your company.
This article discusses the current enforcement emphasis on managed care fraud and examines how managed care organizations can utilize compliance programs, including legal audits, to protect against unwarranted investigations and liability. The article reviews the elements of an effective compliance program, how to conduct an internal audit, and the risks and benefits of a voluntary disclosure in the event fraudulent activity is discovered.
Stratton
K M
KM
Michaels, Wishner & Bonner, Washington, DC, USA.
Nahra
M H
MH
D004650:Employee Performance Appraisal; D005375:Financial Audit; D005607:Fraud / Q000191:economics / Q000517:prevention & control*; D007318:Inservice Training; D016365:Liability, Legal; D008329:Managed Care Programs / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D008330:Management Audit; D012308:Risk Management / Q000458:organization & administration*; D012650:Self Disclosure; D014481:United States