Healthcare Compliance Manager

1-888-522-9775

Casey Moore, Healthcare Compliance Manager (509) 634-2611

Mission Statement: The mission of the Colville Tribes Healthcare Compliance Program is to promote an ethical culture of compliance for all Health Service Programs (HSP) that encourages ethical conduct and a commitment to compliance with the law and to otherwise make a good faith effort to detect and prevent criminal conduct.

Services Provided: The primary services provided by the Healthcare Compliance Program include: monitoring the Tribes day to day compliance activities, analyzing the Tribes’ risk areas, performing and arranging internal and external audits and investigations. The Compliance Manager is Responsible for training and education to all Health Service Program employees regarding the Healthcare Compliance Manual as well as all HIPAA/privacy and security policies. The Compliance Committee supports the Compliance Manager who ensures the Tribe is meeting provisions of the Voluntary Tribal Compliance Agreement with the Office of Inspector General (OIG). The Compliance Program also validates screening for all current and prospective persons to confirm they are not ineligible to bill for federal funding. The Healthcare Compliance Program coordinates with the Centralized Medical Billing program to guarantee any overpayments are paid within 60 days of discovery. The program reports directly to the HHS committee and provides annual reports to the OIG.

Success Stories: The Tribes successfully passed the first year of the Voluntary Tribal Compliance Agreement which included hiring and completing a comprehensive claims review with an independent review origination. The Program finalized the Healthcare Compliance Manual and engaged a compliance software system to consolidate all compliance policies and procedures. The tribes also provided the following training, HIPAA, Updates to C.F.R. 42.2, and Writing Policies and Procedures. In addition the program offered specialized assistance to many programs providing samples, templates, and best practices for policy and procedure development.

 
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