Protecting our partners.
SpecialtyCare believes it is incumbent upon all providers to be good stewards of the business of healthcare.
ACCREDITED BY THE JOINT COMMISSION
SpecialtyCare maintains a comprehensive compliance program to help protect our business partners and to support our belief that providers should be good stewards of the business side of health care. To prevent incurring damages, penalties, criminal sanctions, and/or administrative remedies, physicians and hospitals must comply with all applicable federal and state laws, including:
- The Anti-Kickback Statute
- The False Claims Act
- The Health Insurance Portability and Accountability Act (HIPAA)
- The Stark Law
They must also ensure any allied partners are compliant with applicable laws governing the services they provide. If not, the actions (or possibly inactions) of those partners could create compliance issues for their organization.
SpecialtyCare Specializes in Healthcare Compliance
At SpecialtyCare, adhering to applicable laws and helping protect our clients from the risk of compliance violations is simply part of our standard process. It’s integral to who we are and how we operate. Maintaining compliance is a key component of our overall service model and reinforces our ability to provide our partners and patients with the best possible clinical and financial outcomes.
We maintain a comprehensive compliance program that helps limit exposure for our partners by:
- Training employees on healthcare statutes, regulations, and other compliance directives upon hire and periodically thereafter
- Conducting exclusion list checks to ensure we do not hire or retain employees who have been excluded by federal or state programs
- Offering a secure, anonymous process for receiving complaints or compliance concerns to encourage issue reporting
- Monitoring certain operations for compliance (e.g., billing to help ensure submitted claims comply with government and private payer requirements, which can help reduce the chance of false claims allegations)
SpecialtyCare also maintains a compliance committee, comprised of leaders from key functional areas, to assist with:
- Monitoring employee adherence to compliance program requirements
- Identifying and addressing education or training needs unique to certain functional areas
- Investigating compliance allegations
- Implementing corrective actions
Accredited and certified by The Joint Commission – evidence of our commitment to a higher standard of service and care.
Members of the public and the SpecialtyCare team may contact The Joint Commission’s Office of Quality Monitoring to report any concerns about the quality and safety of patient care by calling 800.994.6610 or emailing [email protected]
Reducing the Risk of Improper Relationships
In addition to our compliance program, SpecialtyCare and persons in our ownership structure are not in a position to make or directly influence referrals or generate business for us or client facilities. We understand the complexities associated with specific healthcare laws, including the Anti-Kickback Statute and Stark Law, and the restrictions those laws place on the relationships and transactions between an allied partner and customer facilities. We also adhere to practices that restrict providing certain items of value to customer facilities or related surgeons due to the risk of implicating all parties under applicable laws (e.g., inappropriate gifts or provision of free services or equipment in exchange for the referral of services that are reimbursed by third parties).
It is vital that we keep SpecialtyCare and our customers in compliance with applicable federal and state statutes and regulations to reduce the risk of fraud, waste, and abuse allegations. Ultimately, our compliance program results in better outcomes through the conscientious delivery of healthcare, and it helps minimize the financial risks and reputational damage that can be caused by non-compliant service providers.
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