Description
CASE STUDY WEEK FIVE: COMPLIANCE
The Office of the Inspector General focuses on the provision of guidelines for compliance pertaining to physician group practices. One may think that the seven core elements of compliance are fully understood, however, each of these elements takes a great deal of time and energy to complete for any group practice.
The Fairway medical group is located in the state of Newberry. They have five facilities at this time. Each of the facilities consists of eight physicians, sixteen employees, and twelve contracts with acute hospitals. One of the centers, located in Patton, has not provided four out of the seven core elements of compliance.
The first compliance issue pertains to the lack of written guidelines and policies set forth to demonstrate the organization’s commitment to regulatory commitment.
The second issue of non-compliance was the lack of effective training and education. This training and education are needed for the employees, physicians, and anyone working in a relationship with the group practice.
The third compliance issue dealt with the lack of group practice auditing systems which was not presented in the compliance policies of the group practice. The fourth compliance issue focuses on the lack of documentation and communication within the structured hierarchical structure.
The analysis of this case, must present why the one facility out of five did not meet the compliance criteria. There are many issues that could be presented such as lack of leadership, lack of management, or lack of a hierarchical structure.
For the case study analysis is to be broken down into the following steps.
- Identify the most important facts surrounding the case.
- Identify the key issue or issues.
- Specify alternative courses of action.
- Evaluate each course of action.
- Recommend the best course of action
