Compliance Program

West Florida ACO has a Compliance Plan structured to meet the guidelines as set forth by Medicare Shared Savings Program (Accountable Care Organizations)

Development and implementation of training programs for compliance, conflict of interest, HIPAA, fraud and abuse and other general areas is included in the compliance program and web-based training and auditing programs for the ACO Participants.

WF ACO has designated a compliance officer who has oversight authority over the compliance committee.

Compliance officer: Gail Moran, RN. Phone: 727-808-0111.

The Compliance officer will do the following:

• Oversee and monitor implementation of the Compliance Program
• Review the program to ensure relevance and compliance with current Federal laws
• Ensure the components of the Compliance Program are implemented to reduce fraud, waste, abuse, and mismanagement within the business office and throughout the revenue cycle
• Take corrective action and document compliance issues as necessary
• Encourage reporting of suspected fraud, waste, abuse, or mismanagement (without fear of retaliation) through training and other means of communication
• Notify employees of applicable regulations, procedures, and guidelines

Compliance Committee

The compliance committee is comprised of Dr. Mahender Reddy, Dr. Muhammad Navaz and Dr. Chowdappa. The role of the compliance committee is to assist the compliance officer in carrying out her duties and to assist with development, implementation, and oversight of the compliance program.

ACO Quality Measures

CMS will measure quality of care using 23 nationally recognized measures in four key domains:

1. Patient/caregiver experience (10 measures)

2. Care coordination/patient safety (4 measures)

3. Clinical Care for At-Risk Population

• Diabetes (1 measure)
• Hypertension (1 measure)
• Depression (1 measure)

4. Preventive Health (6 measures)

More information on medicare shared savings program is available at: 

http://www.cms.gov/sharedsavingsprogram/37e_Quality_Measures_Standards.asp#TopOfPage)

Quality Management program for West Florida ACO

WF ACO Quality management program is a comprehensive, integrated and on-going system designed to evaluate the care coordination and patient self-care education. Programs will focus on Home Health care coordination, discharge planning, patient education and medication management. Other community members and providers will be invited to actively participate in the development of the establishment of care plans that include the promotion of evidence based medicine initiatives.

Actions and activities relating to the WF ACO Quality Management Program are delegated by the Board of Managers to the WF ACO Quality Management Steering Committee. The quality management steering committee is composed of ACO physician participants, nurse coordinator, and is chaired by the Medical director.