SpecialtyCare maintains a comprehensive, enterprise-wide compliance program designed to protect our hospital and physician partners and uphold the highest standards of integrity in healthcare delivery.
Compliance is embedded into our governance structure, operational model, and reimbursement philosophy. Our organization operates in accordance with all applicable federal and state laws, including the Anti-Kickback Statute, False Claims Act, Stark Law, HIPAA, and the No Surprises Act.
Patient Protection
- SpecialtyCare does not balance bill patients, a long-standing policy that predates the No Surprises Act.
- Under the NSA framework, we operate as in-network from the patient’s perspective, resolving reimbursement matters directly with payers.
Responsible Payer Engagement
- We pursue in-network agreements where feasible and engage in ongoing, good-faith contracting.
- Our Independent Dispute Resolution (IDR) process is managed internally and reviewed at the senior leadership level to ensure alignment with a conservative, compliant billing philosophy.
- We seek fair market value reimbursement and do not pursue aggressive or inflated revenue strategies.
Risk-Conscious Partnership
Unsustainable payer rates for high-acuity, hospital-based care can shift financial or operational burden back to hospitals. Our approach is intentionally measured and sustainable, supporting patient protection, institutional compliance, and long-term partnership stability.
At SpecialtyCare, compliance and billing integrity are integral to how we deliver clinical excellence and protect the organizations we serve.
Leadership Commitment
“As regulations evolve, our responsibility remains constant: operate with integrity, transparency, and strict adherence to the law. Compliance is not simply about mitigating risk, it is about protecting our partners, safeguarding patients, and preserving trust. Our billing philosophy reflects a deliberate, measured approach grounded in fairness and sustainability.”
— Steve Lunn, Chief Operating Officer, SpecialtyCare
