Healthcare Compliance (HC_COM)

HC_COM 410-DL Healthcare Regulatory Environment (1 Unit)  

This course facilitates an in-depth exploration of the healthcare laws, regulations, statutes, policy guidance and enforcement initiatives that serve as a framework for healthcare compliance. Topics include but are not limited to legal and ethical issues, patient safety, patient privacy and security, coding and billing, conflict of interest, anti-kickback, and False Claims.

HC_COM 411-DL Healthcare Programs and Enforcement (1 Unit)  

This course provides a comprehensive overview of health care compliance programs, including each of the seven core elements and strategies for developing, implementing and managing effective compliance programs in a heavily regulated environment. The course describes compliance healthcare enforcement authorities, such as Medicare and Medicaid auditors (e.g., Recovery Auditors, UPIC's) and current key healthcare fraud initiatives. Topics also include the basics of conducting risk assessments, audits and investigations. Previous title: Healthcare Compliance Programs.

HC_COM 413-DL Healthcare Billing Models & Systems (1 Unit)  

This course provides a basic understanding of billing and payment structure for healthcare services in the U.S. and systems that promote compliance with federal and state laws, audits, and communications with government and other parties. See the MSRC website for more details.

HC_COM 415-DL IT Systems Compliance (1 Unit)  

Provides a working knowledge of the compliance oversight of healthcare IT systems. Focus is on systems used in healthcare service provider settings. Topics include identification of legal and regulatory computer system requirements used in the industry; ensuring system specifications and configurations meet regulatory requirements; setting criteria of system documentation to ensure compliance to inspectors; ensuring cyber security risks are mitigated; addressing European Union Privacy Laws for international systems; and identifying special considerations for mobile devices. Students will have the ability to manage the compliance aspects of IT systems throughout the system lifecycle (acquisition, upgrades and retirement). Students learn how to build procedures to address any system violations.