decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Managed Care Model Compliance Plan / Essentials of OIG's Managed Care Model Compliance Plan
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Article Overview
This premium article reviews the essentials of the OIG’s managed care model compliance plan and explains the major compliance program components it emphasizes. It is useful for managed care organizations, compliance officers, auditors, and other healthcare administration professionals who need a high-level understanding of program expectations, risk-area focus, reporting structure, training, auditing, and corrective-action processes. The content also references broader OIG guidance areas that shape compliance planning.
Why This Topic Matters
Managed care organizations need practical guidance for building and maintaining compliance programs that align with OIG expectations. This article helps readers understand the main program elements and the general types of oversight and internal controls that are emphasized in managed care compliance planning.
What You Will Learn
- The major components of a managed care compliance plan
- How compliance leadership and oversight are structured
- The role of reporting mechanisms, training, auditing, and corrective action
- How OIG compliance guidance is framed for managed care plans
- Which broad risk areas are highlighted as part of compliance planning
Who Should Read This
- Managed care organization leaders
- Compliance officers
- Healthcare auditors
- Healthcare administrators
- Risk management professionals
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