Corporate Integrity Agreements
Corporate Integrity Agreements (CIAs) are agreements between the U.S. Department of Health and Human Services' (DHHS) Office of Inspector General's office and health care organizations that have inadvertently run afoul of billing or coding practices with Medicare, Medicaid, or other Federal health care programs. As part of the terms of the CIA, health care organizations are often required to seek out an Independent Review Organization (IRO) to help ensure compliance with the terms of the Agreement.
MET, a qualified, URAC accredited IRO with extensive experience in conducting independent compliance reviews, has been serving the healthcare community and their CIA requirements for over a decade with highly qualified, experienced, and independent professionals from a variety of healthcare settings to ensure compliance.
MET provides expert insight and cost savings, as well as onsite visits, nationwide, for those situations in which the complexity and requirements of the CIA might make an onsite visit easier for your organization's compliance.
IRO Review Services:
We focus on providing high-quality compliance services to help health care organizations.
Our team of IRO consultants, including medical doctors, coding experts, and medical professionals from different specialties, uses evidence-based medical best practices to manage your specific compliance issues, helping your organization ensure compliance with the terms of your CIA.
CIAs often require IRO reviews of the arrangements entered into by a health care organization with other health care providers, practitioners, suppliers, and vendors. The IRO is obligated to ensure compliance with the provisions of the Federal Anti-kickback Statute and the Stark Law, as well as other CIA requirements.
MET conducts comprehensive audits to ensure your arrangements are in compliance with the CIA's requirements.
Your organization's CIA may require an IRO review of your claims process.
Although an initial review of a small sample of claims may result in a determination of CIA compliance, the review may trigger, based on discovered statistical anomalies, a more extensive review of a larger, statistically-valid sample.
MET uses certified auditors/coders to help ensure that your claims are in compliance with federal regulations and the requirements of your CIA.
Your CIA may require that an IRO review the entirety of your organization's policies and processes.
Let MET's IRO-trained reviewers examine all your ongoing systems to ensure your CIA compliance is being met.
Marketing Practices Reviews
Your CIA may require you to have an IRO review your marketing practices.
MET consultants have the necessary professional training and expertise to conduct marketing reviews and determine whether your current marketing practices are being conducted in compliance with federal requirements and standards.