From the College | Issue: March 2015 |
Effective management of healthcare compliance requires an office compliance plan that stays current with changing government regulations, payer requirements, office operations and technology. Many still wonder, why is a compliance program needed—if something isn’t broken, don’t fix it, right? This is not always the case; compliance is an essential part of practice operations, but providing…
Compliance programs are an effort by the government to maintain integrity in the healthcare system. These programs target activities causing improper payment to determine their root cause: Was it a mistake or error, was it inefficiency or waste of resources, is the provider bending the rules or abusing the system, or was it intentional deception or fraud? There are also laws dictating the compliance culture within practices and institutions; for example, red-flag rules, antikickback statute, and stark law, to name a few.
Know what’s included in the federal False Claims Act, Anti-Kickback Statute and other regulations and guidelines to prevent Medicare abuse
Approximately 10 years ago, the Office of Inspector General (OIG) issued its first guidance on compliance as it relates to federal mandates for physician practices. Although taking the necessary steps can be a daunting task in an era of complex rules and heightened regulations, there are key areas of government-mandated compliance requirements that practices should…