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Compliance 360 Helps Healthcare Providers
Reduce Risk and Scope of Medicare RAC Audits
Proactive Approach Reduces Audit Cost Liability and Improves Revenue
Cycles
Atlanta, GA. – August 5, 2008– Compliance 360, a leading
provider of on-demand software solutions for enterprise governance,
risk management and compliance (eGRC) and the most widely used solution
in the healthcare industry, announced today that its healthcare provider
customers are using the compliance software solution to proactively
reduce the likelihood of audits conducted under the Medicare Recovery
Audit Contractor (RAC) program.
In June 2008, the Centers for Medicare and Medicaid Services (CMS)
reported that Medicare has corrected more than $1 billion in improper
payments through the Recovery Audit Contractor (RAC) program since
2005, with 85 percent of the corrected payments coming from hospitals.
Thus far, the RAC program has been conducted as a limited pilot in
several states, with plans to begin the nation wide rollout later
this year. According to CMS figures from 2007, estimated improper
Medicare payments exceed $10 billion annually.
“Based on the results so far from the RAC pilot program and
the projected figures going forward with the fully deployed program
as planned, the potential cost to healthcare providers is significant
and they need to begin preparing now,” said Steve McGraw, president
and CEO of Compliance 360. “Much of the current focus in the
healthcare community is based on a reactive strategy of response,
rebuttal and appeal. In light of the impending onslaught of RAC audits,
this is a very short sighted approach that may leave healthcare providers
exposed to a great deal of financial risk. A RAC preparedness program
should also include proactive strategies that focus on reducing the
likelihood of RAC audits and minimizing the scope of RAC audits should
they occur. Regardless of positive or negative outcomes, audits and
appeals result in overhead that eats away at the bottom line. Healthcare
providers are much better off if they can start by simply reducing
their risks in the first place.”
As an example of the value of taking a proactive approach, in a
recent letter from the Office of the Inspector General (OIG), healthcare
providers were advised to adopt proactive programs for compliance
testing, error prevention and self-disclosure. By doing so, healthcare
organizations that can demonstrate effective programs, may be able
to avoid the requirement to sign a corporate integrity agreement
(CIA) with the OIG as a result of claims errors.
The Compliance 360 solution is being used today by leading healthcare
providers to support both their proactive compliance programs as
well as their response and appeal initiatives related to RAC and
other medical records audits. The system provides robust capabilities
for facilitating internal audits and self assessments to proactively
identify outlier cases based on standard practices for diagnosis
related groups (DRG’s). As a result, hospitals can identify
and address claims errors and outliers before they are submitted,
thus reducing the number of claims denials and the likelihood of
raising the red flag with auditors. The Compliance 360 solution also
facilitates audit response and appeal requirements with the project
management and workflow needed to collaborate on compliance-related
incidents and track the progress of investigations. The unique Virtual
Evidence Room™ links all activities and documents to demonstrate
proof of compliance in an easily accessible view for internal and
external audits. Extensive reporting capabilities support analysis
requirements as well as summary information for executives.
“Our solution is helping many hospitals manage both their
proactive compliance programs and audit response requirements today,
and we will be keeping a close watch on this watershed Medicare compliance
program going forward,” said Debbie Luyk, director of product
management for Compliance 360. “As a premiere provider of comprehensive
compliance and risk management solutions for healthcare providers,
we will ensure that the Compliance 360 solution addresses the unique
requirements created by the Medicare RAC program as it evolves.”
Compliance 360 will host a webinar event on August 21, 2008 titled “Preparing
for CMS RAC Audits: Minimize Your RAC Losses - Maximize Your Quality
of Care”. To learn more, about the Compliance 360 solution
for Healthcare, visit www.compliance360.com/healthcare. To learn
more and register for the RAC webinar event, visit www.compliance360.com/RACwebinar.
About Compliance 360 for Healthcare
The Compliance 360 on-demand solution for healthcare providers enables
a holistic approach to regulatory compliance and risk management
through one comprehensive, enterprise-wide platform. With this
solution, healthcare providers have the unique ability to link
all their compliance activities and documentation to the pertinent
regulations through a Virtual Evidence Room™. The Compliance
360 solution for healthcare providers includes policy management,
centralized regulation repository, incident management, reporting,
contract management, surveys, remediation projects, audit management,
self assessment, and enterprise risk management. Industry leading
healthcare providers that depend on Compliance 360 include Billings
Clinic, Catholic Healthcare Systems, IASIS Healthcare, InterDent,
Jackson Memorial Hospital, LifeLink Foundation, MultiCare Health
System, Nassau University Medical Center, PeaceHealth, Saint Joseph's
Hospital of Atlanta, St. Elizabeth Medical Center, St. Luke's Regional
Medical Center and Spectrum Health. To learn more about the Compliance
360 solution for healthcare, visit www.compliance360.com/healthcare.
About Compliance 360
Compliance 360 is a leading provider of enterprise governance, risk
management and compliance solutions for companies that operate
in highly regulated industries. The Compliance 360 on-demand solution
suite addresses IT governance, policies and procedures management,
incident management, surveys, Sarbanes Oxley compliance and enterprise
risk management. Customers benefit by reducing risks, improving
efficiencies, accelerating revenue cycles and protecting their
brands. Compliance 360 is headquartered in Atlanta, GA and assists
over 93,000 users everyday in a variety of highly regulated complex
business environments including healthcare, insurance, financial
services and others. For more information, visit http://www.compliance360.com/.
Editor’s Note: Compliance 360 is a registered trademark of
Compliance 360, Inc. Virtual Evidence Room is a registered service
mark of Compliance 360, Inc. All other trademarks are recognized
as proprietary to their owners.
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Media Contact:
Scot Mcleod
VP of Marketing
Tel: (678)-992-0262
media@compliance360.com |
