FACS Quality Assurance and Compliance

Florida Accountable Care Services operates an internal Quality Assurance (QA) Program and Compliance Program.  The Quality Assurance program is designed to objectively and systematically monitor and evaluate the extent to which FACS ACOs satisfy contractually based commitments to CMS and Commercial Payors.  Operation of the QA Program is guided by an internal Quality Assurance and Medical Standards Committee.  The committee is composed of licensed and active physician providers who are members of the FACS Medicare and Commercial ACO networks, ancillary service providers, and is chaired by the FACS Chief Quality Officer.

The FACS Compliance Program is designed to promote adherence to appropriate standards of business conduct throughout all aspects of the FACS ACO operations and ensure compliance with applicable federal, state, and local statutory and regulatory obligations by FACS as well as the contracted entities (i.e., Privacy Act of 1974, HIPAA, Health Information Technology for Economic and Clinical Health [HITECH] Act).

The Program operates from policies and procedures that ensure compliance to regulations that govern sharing of personal health information (PHI) and vigilant surveillance of fraud, waste, and abuse, including:

1. 1. Initial and annual mandatory fraud, waste, and abuse training for FACS staff and business associates,
   2. Monitoring contracted entities for potential fraud, waste, and abuse, and
   3. Reporting fraud, waste, and abuse to appropriate agencies and organizations.