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本科毕业论文(设计)
外 文 翻 译
外文题目 Independent Review Organizations Must Meet GAO Yellow Book Standards
外文出处 Journal of Health Care Compliance,2010(2):27-32
外文作者 Herrmann Thomas E
原文:
Independent Review Organizations Must Meet GAO “Yellow Book” Standards
BACKGROUND
On July 30, 2001, the OIG, in conjunction with the Health Care Compliance Association (HCCA), cosponsored a Government Industry Roundtable to discuss “issues surrounding the implementation and maintenance of effective compliance programs.” Specifically addressed in the discussion was the OIG’s requirement, in the context of health care fraud and abuse settlements, that an IRO be retained by a health care entity to perform annual billing, systems, and/or other compliance reviews. Participants recognized that:
The OIG requires IROs because the OIG does not have the resources to conduct the level of review necessary to determine if a provider is meeting the requirements of the CIA as well as other Federal health care program requirements. Additionally, a review by an independent entity provides the OIG with assurances that a provider’s compliance program and billing systems are objectively reviewed.
Roundtable participants referenced a number of advantages associated with using an IRO. “IROs provide a broad industry perspective and expertise, are independent, help identify system weaknesses, make helpful recommendations, and their reviews serve as a useful benchmark for future reviews conducted by the provider.”
OIG REQUIREMENTS FOR IRO INDEPENDENCE
The obligations for an audit/review organization, such as an IRO, to meet “independence” standards are referenced in GAGAS as set forth by the GAO in its “Yellow Book.” These standards are applicable to financial audits, typically performed by certified public accountants (CPAs), attestation engagements, and performance audits, which may be
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