Read the HFM Magazine article, featuring SAI Global's COO, GRC Solutions - Jan Kruger.
Managing low-dollar, high-volume claim denials associated with outpatient procedures is a challenge for many hospitals because of the expense involved in manually reviewing such denials. These denials are often the source of “hidden loss” for hospitals. For some hospitals, the most practical, cost-effective approach for managing low-dollar, high-volume claim denials will include the use of automated systems to monitor and highlight denials and expose trends.
Are your employees lying about telling the truth? The unique challenges of ethics and compliance measurement27 Mar 2014 Written by James D. Meacham
The primary goal of most Chief Compliance Officers is to decrease compliance risk by increasing ethical behavior. One of the most difficult questions in pursuit of that goal is how to measure progress. Unfortunately, ethical behavior can’t be directly measured, so the measurements compliance officers rely on are actually proxies for ethical behavior. For compliance programs that have reached a degree of maturity, surveys are among the most commonly used broad-based tool for measuring employee knowledge, attitudes, and buy-in regarding compliance and ethics.
The United Kingdom Financial Conduct Authority (FCA) has made available a Final Notice (19 December 2013) fining Jardine Lloyd Thompson Group plc (JLT Group) subsidiary JLT Specialty Ltd (JLTSL) £1.876 million for its failure to properly deploy its risk management checks in relation to its business with foreign entities over a period of three years.
Many regulations have extended compliance programs beyond the borders of individual companies to related third parties. In particular, the supply chain has been subject to additional rules and reporting and disclosure requirements. Compliance officers must be wondering “where do I start?”
Mary Frances Monroe
Senior Director - Trelient Risk Advisors, LLC
Carol Stern, B.A, FLMI, AIRC, ACS
Senior Consultant - First Consulting Operational Compliance Practice
Omnibus, Business Associates and Breaches: Innovative New Approaches for Identifying and Mitigating Risk02 Aug 2013
Cliff Baker, Managing Partner - Meditology
Tyrone Jeffress, Manager - Meditology
The United States (US) Environmental Protection Agency (EPA) has announced that an Idaho-based cheese manufacturer will pay US$91,352 to settle breaches of chemical accident prevention regulations under the Clean Air Act.
Martin Bishop, Partner
Foley & Lardner LLP
Rebecca R. Hanson, Senior Counsel
Foley & Lardner LLP
Third Party Risk Management is rapidly growing in importance as organizations increasingly turn to outsource providers to reduce operating costs, extend their business, and increase their focus on core competencies. Amid the benefits of outsourcing, there lie significant risks. For example, in recent years, governments across the globe have increased their focus on anti-corruption as evidenced by enforcement actions and fines against organizations for the actions of third party business partners. Simply stated, responsibility and liability cannot be outsourced. One-time efforts during on-boarding, contract renewals, or point-in-time investigations may be manageable but not defensible.
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- Anti-Money Laundering (1)
- Authors (34)
- Business Ethics & Corporate Culture (28)
- Careful Communication & Proper Use of Computers (3)
- Code of Conduct (3)
- Competition (8)
- Compliance & Ethics Learning (1)
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- Vignettes and enactments are effective tools in… Written by Mary Snyder 2012-01-12 17:15:57 Employment Law Regarding Harassment (Expert Commentaries)