HealthPlus of Michigan Corporate Compliance Program
Background
HealthPlus of Michigan, Inc. and its Subsidiaries, including HealthPlus Partners, Inc., HealthPlus Options, and HealthPlus Insurance Company, have established and currently maintain practices and procedures which collectively comprise the HealthPlus Corporate Compliance Program. This program is intended to prevent, detect, and correct any illegal or improper conduct. Federal and state laws and regulations, Medicare, Medicaid, OFIS (Office of Financial and Insurance Service), and other agencies all contribute to the regulations organizations are to follow in their compliance programs. Basically, the Compliance Program consists of rules and regulations for both HIPAA (Privacy and Security) and Fraud & Abuse. The Compliance Program Description specifies the structure, policies, procedures, and practices that constitute the HealthPlus Compliance Program. Compliance is not a “policing” action, but a way to ensure everyone is “doing the right thing”. To support this, HealthPlus’ Corporate Compliance Program is designed around seven primary functions:
A) Establishing compliance policies and procedures
B) Business structure and responsibility
C) Education/training
D) Reporting mechanisms
E) Response/prevention
F) Auditing/inventory
G) Responding to detected offenses and developing corrective actions
All levels of the organization are responsible for assuring HealthPlus’ actions are appropriate –employees, providers, members, vendors, and the Board of Directors. Once an issue is identified, the Compliance Department works with the applicable departments to investigate and resolve the issue. All issues are recorded and tracked for timely resolution.
For more Information, please access the following pages:
Updated 1/24/2007
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