Effective compliance programs must include regular monitoring and auditing of areas identified as high-risk for non-compliance with laws and regulations. Regulators have identified a number of compliance risk areas for regular monitoring and auditing, including claims submitted to federal health care programs, financial relationships with physicians, quality of care, and the privacy and security of patient information.
SoNE HEALTH conducts annual and periodic risk assessments in connection with development of annual compliance and internal audit work plans, compliance risks identified include audit and regulatory enforcement priorities of DHHS – OIG, CMS, the Department of Justice (DOJ), Internal Revenue Service (IRS), and others.
The results of audits conducted by CMS contractors, internal audits, and other factors are considered in the annual risk assessment and planning process.
SoNE HEALTH monitors the completion status of management action plans developed in response to audit findings. Reports are issued on a quarterly basis to the Chief Compliance & Privacy Officer and other senior leaders to assist in this effort.