| The Federal Sentencing Guidelines have been recognized as standards, by the Department of Health and Human Services and the Office of Inspector General, for the implementation of effective compliance programs in hospitals. In this capstone, a developmental model for hospital administrators to implement compliance programs in the hospital setting was highlighted. Through a literature review of scholarly articles and research of healthcare compliance regulatory agencies, a compliance model based upon the Federal Sentencing Guidelines was developed. This can enable hospitals to decrease their chance of violating healthcare regulations such as fraud and abuse laws implementing effective compliance programs. Also reviewed were the different healthcare fraud and abuse laws, regulations, and penalties in order to demonstrate why it was important for hospitals to adopt an effective compliance program. Findings demonstrated that hospital administrators, who have adopted compliance programs, using the Federal Sentencing as its guidelines, had civil and criminal penalties mitigated if they were found guilty of violating federal healthcare fraud and abuse laws and regulations. The developmental model presented was based on the Federal Sentencing Guidelines and provides a roadmap for adopting best practices and sustaining a high level of compliance within the hospital setting. Keywords: Health Care Administration, Dr. Dana Hart, Professor Maria DeGiglio, Stark law, Anti-Kickback law, code of conduct, compliance officer, policies and procedures. |
