Page 136 - 2020 ARE eGuide for Clinical at Nonhospital Sites
P. 136
What happens after non-compliance is detected?
After non-compliance is detected, it must be investigated
immediately and promptly corrected. Internal monitoring
should continue to ensure:
• There is no recurrence of the same non-compliance
• Ongoing compliance with CMS requirements
• Efficient and effective internal controls
• Medicare patients are protected
Non-compliance affects everybody
Harm to Medicare Patients Less Money for Everyone
• Delayed services • High insurance payments
• Denial of benefits • Higher premiums
• Limited provider choice • Lower benefits
• Other hurdles to care • Lower Star ratings
• Lower profits
