Corporate Compliance Program
Hunterdon Healthcare (“Hunterdon”) is committed to carrying out its mission lawfully and ethically. The Corporate Compliance Program (“CCP”) was developed to provide consistent and accurate communication of corporate policies and procedures in the areas of compliance with federal and state laws, regulations and Hunterdon’s Code of Ethics. The CCP is intended to guide and support each team member in undertaking responsibility for an environment of compliance. High standards of ethical conduct will be maintained in all practices including, but not limited to: patient care, admission, transfer, discharge, billing, marketing, and relationships with other healthcare providers, educational institutions, payers, contractors and vendors.
Elements of the program include setting and communicating standards (the Code and Policies and Procedures), education, providing a mechanism for reporting possible violations of Hunterdon’s internal policies or external laws or regulations, monitoring and auditing to identify and address any potential instances of fraud or abuse of governmental health insurance programs, and maintaining an organizational structure that supports the furtherance of the program. Hunterdon recognizes that the benefits of having an effective compliance plan and program include:
- demonstrating to providers and staff members and the community Hunterdon’s strong commitment to honest and responsible provider conduct;
- identifying and preventing unethical and criminal conduct;
- improving the quality of patient care through better documentation;
- minimizing billing mistakes, thereby optimizing proper payment of claims;
- reducing chances of a negative outcome if audited by the government;
- minimizing the risk of violations of Federal and state laws, rules and regulations governing the operation of the Practice, including but not limited to the Anti-Kickback Statute and Stark Law;
- developing and maintaining a culture, and implementing reporting procedures, that encourage(s) providers and staff members to report potential problems; and
- the ability to promptly detect and report potential or actual violations and initiate immediate and appropriate corrective action.
Hunterdon Compliance Hotline: 908-788-2585
The Hunterdon Compliance Program has an established Compliance Hotline. The Compliance Hotline is a voicemail system available 24 hours a day, seven days a week. The hotline enables Hunterdon employees, medical staff, visitors, contractors, patients or vendors to report compliance related issues or possible violations of patient privacy or confidentiality. Calls to Hunterdon’s Compliance Hotline can be made anonymously if the caller chooses. All calls are kept confidential and anonymity is protected to the extent allowable by law. All team members are protected against retaliation for reporting an issue in good faith. Callers do not have to provide their identities to make a report.
Centers for Medicare and Medicaid Services (CMS) administers the Medicare program, and works in partnership with the States to administer Medicaid.
The Office of Inspector General (OIG) protects the integrity of Department of Health and Human Services (HHS) programs through a nationwide network of audits, investigations, and inspections.
The Office of Civil Rights (OCR) helps to protect the privacy of your health information held by certain health care providers and health insurers.
The NJ Dept of Human Services – Division of Medical Assistance and Health Services (DMAHS) administers the state- and federally-funded Medicaid and NJ FamilyCare programs for certain groups of low- to moderate-income adults and children. Through these programs, DMAHS serves about 1.3 million New Jersey residents.
New Jersey State Department of Health (NJDOH) oversees all aspects of public health services. It is responsible for oversight of health care institutions, hospital financing, public health and environmental laboratory services, senior services, health care policy and research, minority and multi-cultural health and preparedness for and response to all health-related aspects of terrorism.
The Food and Drug Administration (FDA) is an agency within the Department of Health and Human Services. The FDA is responsible for protecting the public health by assuring the safety, efficacy, and security of human and veterinary drugs, biological products, medical devices, our nation’s food supply, cosmetics, products that emit radiation, and tobacco products.
The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.
The New Jersey Hospital Association (NJHA) is a not-for-profit trade organization committed to delivering support and services to the state’s hospitals and other healthcare providers, with close to 400 healthcare organizations including hospitals, health systems, nursing homes, home health agencies, hospice providers and healthcare-related business and educational institutions in its membership ranks.
The Health Care Compliance Association (HCCA) exists to champion ethical practices and compliance standards and to provide the necessary resources for ethics and compliance professionals and others who share these principles.
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