Know what’s included in the federal False Claims Act, Anti-Kickback Statute and other regulations and guidelines to prevent Medicare abuse
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.
CHICAGO—Medical practice consultant Owen Dahl, MBA, LFACHE, CHBC, looked out at the rheumatology practice managers and physicians, sitting around tables with white tablecloths, and asked what seemed like a simple question: “How many of you have a strategic plan?” he asked. A single hand was raised. “One? How do you know where to go tomorrow…
Early last fall, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its OIG Work Plan for fiscal year 2018–2019, which is a two-year framework for the audits, inspections, evaluations and investigative activities planned in support of its vision, mission, and strategic goals and objectives to maintain HHS program integrity….