The Affordable Care Act Essay Assignment Paper
The Affordable Care Act (ACA) is a comprehensive health care reform law that was enacted in 2010. As a legislation, ACA has three primary goals. First, making affordable health insurance available to more Americans. Second, expanding the Medicaid program to cover more beneficiaries. Third, supporting innovative medical care delivery methods. ACA mandates compliance programs for health care organizations (providers) who use Children’s Health Insurance Program (CHIP), Medicaid and Medicare. While it sets specific mandates for organizations, the intent is to ensure that the compliance programs are implemented. The legislation acknowledges that effective compliance programs are an essential component for navigating the complex world of the benefits programs managed by the government (Kominski, Nonzee & Sorensen, 2017) The Affordable Care Act Essay Assignment Paper.
ORDER YOUR PAPER HERE
Having a good compliance program is expected to provide significant benefits for the organization to include: saving staff time by avoiding duplications; promoting patient safety and ensuring that high quality patient care is delivered; avoiding the potential for fraud, waste and abuse; improving claims review results; reducing mistakes in billing; and increasing potential for proper submission and payment of claims (McIntyre & Song, 2019). Towards this end, the legislation presents requirements of which three are discussed in this paper The Affordable Care Act Essay Assignment Paper.
First, requirement for written policies, procedures and standard of conduct that are composed with guidance from the compliance committee and compliance officer. Establishing these in writing is necessary for promoting uniformity and consistency. The requirement is for the writings to be readily available to all personnel and be reviewed by them within three months of being hired and at least once yearly. The organization has complied with this requirement by creating a written code of conduct that is compiled through consultations, availed to all personnel, regularly reviewed, clarifies what ethical and non-ethical conduct implies, and details procedures followed to handle cases of unethical conduct. The code of conduct is specific, details, easy to read, and easy to comprehend (Department of Health Care Finance, 2018)The Affordable Care Act Essay Assignment Paper.
Second, requirement for compliance program oversight. There is an understanding that ACA requirements has a lot of requirements. The presence of a compliance committee and compliance officer is necessary for overseeing the workings of the compliance program and structure. The compliance officer is responsible for the daily workings of the compliance program and structure. The organization has met this requirement by creating a compliance office that includes a compliance officer and a multidisciplinary compliance committee. The compliance office oversees ACA compliance program structure and administration within the organization. Also, the office is responsible for oversight in assessing compliance programs, reporting compliance enforcement activities, informing about outcomes of monitoring and audits, administering the compliance program structure, and approving the standards of conduct (Department of Health Care Finance, 2018)The Affordable Care Act Essay Assignment Paper.
Third, requirement for training and education with the expectation that all personnel will be trained to ensure that they are aware of all the standards and expectations. The training program must effectively communication the compliance program requirements and the organization’s code of conduct. The organization has met this requirement by establishing annual trainings that update personnel on program changes and new developments. The training offers refresher compliance education, provides initial compliance training for new personnel, and general compliance training that communicates the requirement of the compliance programs. The training programs are interactive to increase takeaway value, and use compliance and non-compliance scenarios that personnel may encounter (Department of Health Care Finance, 2018). Overall, the organization understands the need for meeting ACA compliance requirements, and has undertaken the three discussed measures to ensure active compliance The Affordable Care Act Essay Assignment Paper.
ORDER YOUR PAPER HERE
References
Department of Health Care Finance (2018). Provider Compliance Program Guidance. https://dhcf.dc.gov/sites/default/files/dc/sites/dhcf/page_content/attachments/DHCF%20Provider%20Compliance%20Program%20Guidance%2012182017.docx
Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s Impacts on Access to Insurance and Health Care for Low-Income Populations. Annu Rev Public Health, 38, 489–505. https://dx.doi.org/10.1146/annurev-publhealth-031816-044555
McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a decade. PLoS Medicine, 16(2), e1002752. https://doi.org/10.1371/journal.pmed.1002752
Assessment Description
The Affordable Care Act (ACA) identifies requirements related to provider compliance with fraud, waste, and abuse laws that have been enacted to protect consumers. Research three of these requirements and describe the corresponding measures that your health care organization has initiated, or could initiate, to comply with the ACA. Support your analysis with a minimum of two peer-reviewed articles. The Affordable Care Act Essay Assignment Paper
Assessment Description The Affordable Care Act (ACA) identifies requirements related to provider compliance with fraud, waste, and abuse laws that have been enacted to protect consumers. Research three of these requirements and describe the corresponding measures that your health care organization has initiated, or could initiate, to comply with the ACA. Support your analysis with a minimum of two peer-reviewed articles.