管理式医疗面临困境：有效的合规计划如何保护你的公司。
Managed care under siege: how an effective compliance program can protect your company.
作者信息
Stratton K M, Nahra M H
机构信息
Michaels, Wishner & Bonner, Washington, DC, USA.
出版信息
Manag Care Q. 1996 Winter;4(1):80-5.
PMID:10154069
Abstract
This article discusses the current enforcement emphasis on managed care fraud and examines how managed care organizations can utilize compliance programs, including legal audits, to protect against unwarranted investigations and liability. The article reviews the elements of an effective compliance program, how to conduct an internal audit, and the risks and benefits of a voluntary disclosure in the event fraudulent activity is discovered.
摘要
本文讨论了当前对管理式医疗欺诈的执法重点，并探讨了管理式医疗组织如何利用合规计划（包括法律审计）来防范无端调查和责任。文章回顾了有效合规计划的要素、如何进行内部审计，以及在发现欺诈活动时自愿披露的风险和益处。
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