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Aspirus Compliance Program

Aspirus is committed to the highest standards of conduct in all our operations. Our Compliance Program represents a shared undertaking from the highest levels of management and the Board of Directors to the most junior employees. We expect everyone to take ownership of compliance and to perform all tasks with integrity.

The Aspirus Compliance Program incorporates the elements of an effective compliance program consistent with the Office of Inspector General’s compliance program guidance.

If you have questions about the Aspirus Compliance Program, please feel free to contact us at 715-847-2166.

1. Oversight and Governance StructureOrg Chart

  1. Chief Compliance Officer – The Chief Compliance Officer (CCO) is responsible for overall leadership of our Compliance Program. The CCO reports directly to the Aspirus Board Audit and Compliance Committee and administratively to the Aspirus President CEO.
  2. Board Audit and Compliance Committee – This is a subcommittee of the Aspirus Board of Directors and provides board level oversight and support of the Aspirus Compliance Program.
  3. Compliance Program Executive Committee – This committee consists of senior leaders and provides executive level support of the Compliance Program.
  4. Compliance Program Operations Committee – This committee consists of operational leaders and provides guidance and support to operationalize compliance across the health system.

2. Written Standards and ProceduresStandards of Conduct

  1. Aspirus has developed Compliance policies and procedures to guide our employees, providers and vendors around their conduct of day-to-day operations. We shall review and update them periodically to reflect current standards and practice.
  2. The Aspirus Code of Conduct is an essential resource that outlines our values and provides guidance that is intended to helps reinforce our culture of integrity.

3. Training and EducationTraining

Aspirus is committed to providing effective training to employees, providers, leaders, and directors on Compliance Program responsibilities. Training resources include on-line education as well as access to policies and the Code of Conduct.

4. Effective Lines of CommunicationReporting

Aspirus employees, providers, and vendors can anonymously seek guidance or report suspected violations of the Compliance Program by calling our Compliance Helpline at 800-450-2339.  Retaliation or intimidation against anyone, who in good faith, reports known or suspected violations of our Compliance Program is strictly prohibited.

5. Auditing and MonitoringAuditing

Auditing and monitoring activities help detect and prevent potential violations of law or policy. The Compliance Program performs a risk assessment annually and develops a work plan, which will include auditing and monitoring as well as other risk mitigation activities.

6. InvestigationsInvestigations

The Compliance Department will carefully review and thoroughly investigate all reported concerns regarding suspected or actual violations of the Compliance Program.

7. Corrective/Disciplinary ActionCorrective Action

If it is determined that a violation of the Compliance Program has occurred, appropriate and necessary corrective action is taken in accordance with Aspirus policy.