Discussion response
Megan
Healthcare Organizations have a legal and ethical responsibility to prevent, detect and report fraudulent activity. The incorporation of a HCO handbook detailing the organization’s policies, procedures and compliance to the Joint Commission, encourages compliance and responsibility to all employees. As stated by the The Office of the Inspector General (OIG) of the Department of Health and Human Services’ [t]he purpose of compliance policies and procedures is to establish brightline rules that help employees carry out their job functions in a manner that ensures compliance with Federal health care program requirements and furthers the mission and objective of the hospital itself.” (National Law Review, 2018). The handbook should include topics such as Confidentiality, Fraud, data privacy, organizational safety and professional culture (workplace conduct and employment practices). These policy and procedures are part of the Joint Commision standards and expectations to help HCO provide safe, high quality care.
Handbooks have specific and direct procedure manuals on how a HCO is conduct itself and the policies in which it inforces. The prevention of legal violations is key in protecting patients personal information and the employees themselves. The confidentiality of protected health information (PHI) in regards to The Health Insurance Portability and Accountability Act of 1996 (HIPAA), is at foremost a priority for any HCO. Disclosing or falsifying PHI can result is large monetary fines which are huge losses for HCO. Stating who has access and the specifics of what they have access to should be discussed in the handbook. Especially when all employees are not privy to all PHI. Similarly, The Joint Commision requires its own employees to oblige “In accordance with applicable legal and ethical standards, Joint Commission Personnel shall maintain the confidentiality of The Joint Commission’s intellectual property, employee and financial information, and any confidential proprietary or otherwise sensitive information received from or about health care organizations, including protected personal information.” (The Joint Commission, n.d.).
Incorporating policies for fraudulent behavior such a submitting false billing claims to Medicare of Medicaid would help prevent against any legal action in the False Claim Act. This would also include what to do if fraudulent behavior is detected. Also include is the reporting avenues and employee protection in the event of a whistleblower.
Policy and procedural handbooks work in all HCO, specifically any organization that participates in federally funded payment programs such as Medicare, Medicaid and TRICARE. This includes hospitals, long term care, hospice, military and physicians practicing in the private sector.
This serves as a “best practice” for any HCO that promotes a culture of compliance and responsibility to the patients, employees and itself. By providing the handbook on policies and procedures to all employees, it holds each individual accountable. Each employee should be required to sign acknowledging they will follow all guidelines. Incorporation of handbooks makes it clear how each individual’s plays a part “in the organization’s efforts to prevent, detect, respond to, and report violations of laws, government regulations, and ethical rules.” (National Law Review, 2022).
This best practice is beneficial to not only healthcare organizations but any company/organization that deals with protected personal information(names, social security numbers, drivers license) such as banks and credit card companies
National Law Review. ( 2022, June 8). Seven Fundamental Elements of an Effective Compliance Program. https://www.natlawreview.com/article/seven-fundamental-elements-effective-compliance-program
The Joint Commission, (n.d.). The Joint Commission Code of Conduct Manual. https://www.jointcommission.org/-/media/tjc/documents/about-us/code-of-conduct-manual-121520-final.pdf
Discussion response 2
Chen
Healthcare Organizations have a legal and ethical responsibility to prevent, detect and report fraudulent activity. The incorporation of a HCO handbook detailing the organization’s policies, procedures and compliance to the Joint Commission, encourages compliance and responsibility to all employees. As stated by the The Office of the Inspector General (OIG) of the Department of Health and Human Services’ [t]he purpose of compliance policies and procedures is to establish brightline rules that help employees carry out their job functions in a manner that ensures compliance with Federal health care program requirements and furthers the mission and objective of the hospital itself.” (National Law Review, 2018). The handbook should include topics such as Confidentiality, Fraud, data privacy, organizational safety and professional culture (workplace conduct and employment practices). These policy and procedures are part of the Joint Commision standards and expectations to help HCO provide safe, high quality care.
Handbooks have specific and direct procedure manuals on how a HCO is conduct itself and the policies in which it inforces. The prevention of legal violations is key in protecting patients personal information and the employees themselves. The confidentiality of protected health information (PHI) in regards to The Health Insurance Portability and Accountability Act of 1996 (HIPAA), is at foremost a priority for any HCO. Disclosing or falsifying PHI can result is large monetary fines which are huge losses for HCO. Stating who has access and the specifics of what they have access to should be discussed in the handbook. Especially when all employees are not privy to all PHI. Similarly, The Joint Commision requires its own employees to oblige “In accordance with applicable legal and ethical standards, Joint Commission Personnel shall maintain the confidentiality of The Joint Commission’s intellectual property, employee and financial information, and any confidential proprietary or otherwise sensitive information received from or about health care organizations, including protected personal information.” (The Joint Commission, n.d.).
Incorporating policies for fraudulent behavior such a submitting false billing claims to Medicare of Medicaid would help prevent against any legal action in the False Claim Act. This would also include what to do if fraudulent behavior is detected. Also include is the reporting avenues and employee protection in the event of a whistleblower.
Policy and procedural handbooks work in all HCO, specifically any organization that participates in federally funded payment programs such as Medicare, Medicaid and TRICARE. This includes hospitals, long term care, hospice, military and physicians practicing in the private sector.
This serves as a “best practice” for any HCO that promotes a culture of compliance and responsibility to the patients, employees and itself. By providing the handbook on policies and procedures to all employees, it holds each individual accountable. Each employee should be required to sign acknowledging they will follow all guidelines. Incorporation of handbooks makes it clear how each individual’s plays a part “in the organization’s efforts to prevent, detect, respond to, and report violations of laws, government regulations, and ethical rules.” (National Law Review, 2022).
This best practice is beneficial to not only healthcare organizations but any company/organization that deals with protected personal information(names, social security numbers, drivers license) such as banks and credit card companies
National Law Review. ( 2022, June 8). Seven Fundamental Elements of an Effective Compliance Program. https://www.natlawreview.com/article/seven-fundamental-elements-effective-compliance-program
The Joint Commission, (n.d.). The Joint Commission Code of Conduct Manual. https://www.jointcommission.org/-/media/tjc/documents/about-us/code-of-conduct-manual-121520-final.pdf
Discussion 3
Response 1 paragraph
Thanks for the post. Is it unethical for someone not to get required immunizations? Explain
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