Overview

The California Hospital Compliance Manual is the only publication written for hospital compliance officers that integrates California law and federal law on high-risk compliance areas. Written by Hooper, Lundy & Bookman, PC, and CHA, the 2012 edition has been  updated to reflect changes through Jan. 1, 2012 to Medicare and Medi-Cal reimbursement requirements including physician supervision, three-day payment rule, partial hospitalization, observation status, ACOs and much more.

Major changes to the 2012 edition include:

• Expanded coverage of conflict of interest issues, including a new sample form and revision of the model compliance plan.
• Updates to the three-day payment rule, partial hospitalization, California anti-markup payment limitations, and Medi-Cal observation days.
• A discussion on the CMS/OIG proposed fraud and abuse waivers that protect ACO activities from physician self-referral laws and the anti-kickback statute.
• The Affordable Care Act’s requirements for tax-exempt hospitals from the IRS regarding community health needs assessment, financial assistance policy, etc.
• Information about the IRS initial guidance regarding ACOs and tax issues.
• Recent changes to the Medicare Recovery Auditor program, including new limits on medical records requests and issues that CMS has approved Recovery Auditors to audit.

The manual focuses on the key topics and laws that must be addressed in an effective compliance program. A model compliance plan that hospitals can adapt to fit their operations is available on the free CD. The manual also includes legal citations and an index of key terms.

(Third edition, 2012)

Written By:
Hooper, Lundy & Bookman, PC
California Hospital Association

Content

The manual features over 500 pages of content including 13 chapters, a model hospital compliance plan, numerous compliance forms and appendixes, and an index. A complimentary CD with the model plan and appendixes is also included.

Chapters:

• Hospital Compliance Plans
• Federal and State False Claims Acts
• Submission of Accurate Claims Information
• Proper Cost Reporting Practices
• Physician Self-Referral Laws
• Federal and State Anti-Kickback Laws
• Hospital Fair Pricing Policies
• Issues for Tax-Exempt Hospitals
• Fundamentals of Hospital Licensing and Certification
• Screening for Excluded Providers
• Other Laws
• Repayment and Self-Disclosure
• Responding to Government Audits and Investigations

Reviews

“Simply put, it's an excellent overall resource to support sound compliance programs.”
– Ron Gaasch, Director of Compliance & Privacy Officer, Community Hospital of the Monterey Peninsula

“It’s easy to read and well organized. As a compliance officer with other key roles, I don't have time to look through countless regulations to find answers — this is a one stop shop.”
– Barry Mangels, Director, Risk Management & Chief Compliance Officer, Good Samaritan Hospital, L.A.

“The value of this manual comes from the blend of state and federal information.”
– Robin Kacey, Compliance Officer, Valley Presbyterian Hospital

“Very relevant. Reliable expertise.”
– Angela Anderson, Senior Director, Regulatory Affairs, Washington Hospital

"A single reference source for compliance professionals."
– Dinh Nguyen, Consultant, HC Compliance Solutions