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Research Compliance Committee
- Corporate Director of Mountain States Compliance Department
- HIPAA Officer
- Corporate Director of Mountain States Research Department
Committee meets every 6 months or as necessary to review urgent cases.
The purpose of MSHA's Compliance Program is to:
- Promote the prevention, detection and resolution of instances of conduct that may not conform to federal and state law and federal, state and private payor health care program requirements, as well as MSHA's Code of Ethics and Business Conduct.
- Define team member responsibility to comply with the laws and regulations governing MSHA's operations
- Establish accountability for compliance at the highest operational level of responsibility and sustain a culture where ethical conduct is recognized, valued and exemplified
- Work closely with the MSHA departments responsible for billing accuracy and integrity to ensure that third party claims reflect a strong organizational commitment to uphold honest and responsible conduct.
- Provide a process by which team members can identify and report ;potential fraud, waste and abuse exposure without fear of retaliation or retribution
- Provide guidance to management staff regarding the need for preventive and self-check measures through the use of education, training and monitoring to ensure compliance with all applicable laws and regulations.
- Create a centralized source for the distribution of information relative to guidance and assistance with adherence to applicable federal and state laws, regulations, statues and other requirements.
- Minimize, through early detection and reporting, any potential loss to the government and private payors from erroneous claims, as well as reduce MSHA's [potential exposure to damages and penalties that might result from questionable activities