Compliance

Atlantic Dialysis Management Services and its contracted affiliates (ADMS) is committed to preventing and detecting any fraud, waste, or abuse, especially as related to Federal and State health care programs.  To this end, AMDS maintains a vigorous compliance program and strives to educate its work force on fraud and abuse laws, including the importance of submitting accurate claims and reports to the Federal and State governments.    

In furtherance of this commitment and to comply with Part 521 of Title 18 of the Codes, Rules and Regulations of the State of New York, ADMS provides the following information about its policies and procedures and the role of certain federal and state laws in preventing and detecting fraud, waste and abuse in federal health care programs.

The New York State Office of the Medicaid Inspector General (“OMIG”) adopted regulations stating that New York State providers of care, services and supplies for which the Medicaid program constitutes a substantial portion of their business operations are required to adopt and implement effective compliance plans.

The OMIG regulations also state that the mandatory compliance programs shall be applicable to:

  1. Billings;

  2. Payments;

  3. Medical necessity and quality of care;

  4. Governance;

  5. Mandatory reporting;

  6. Credentialing; and

  7. Other risk areas that are or should with due diligence be identified by the provider.

ADMS has instituted policies and procedures and a compliance program for detecting and preventing fraud.  As part of ADMS’ commitment to ethical and legal conduct, employees are required to immediately bring to the attention of their supervisor any information regarding suspected improper conduct.  Employees, patients or concerned parties may also call the ADMS’ Compliance Officer at (718) 483-7403 to discuss or report concerns about possible violations of the law or institutional policy. ADMS is committed to investigating any such allegation of fraud, waste, or abuse swiftly and thoroughly and will do so through its internal compliance programs and processes.  To ensure that the allegations are fully and fairly investigated, ADMS requires that all employees fully cooperate in such investigations.

The Compliance Program is very important and ADMS devotes resources to investigate allegations. Any employee, patient or concerned party who reports such information can choose to do so anonymously, and will also be protected against retaliation for coming forward with such information both under ADMS’ internal compliance policies and procedures and Federal and State law. 

ADMS employees have a duty to bring their concerns to ADMS so that it may investigate and correct any problems that may exist.  However, certain State and Federal laws provide that any private citizen may bring their concerns of fraud and abuse directly to the government.

Finally, as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), ADMS patients have the right to easy access to their health information. Furthermore, ADMS must protect the privacy and security of patient’s identifiable health information. If you would like a copy of the information, please click on the Medical Record button below. For more information on HIPAA and your rights as a patient, please visit this site.

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