Implement a Healthcare Compliance Program to Protect Your Practice

Filled under: Healthcare Compliance on June 2012

As the healthcare laws and regulations are constantly changing nowadays, you need to be above them and protect your practice with a healthcare compliance plan that will prevent you from dealing with the government and from mitigating the damage, should any trouble occur. The healthcare regulatory enforcement should be taken very seriously, especially since the Health Insurance Portability and Accountability Act of 1996 has provided the Department of Health and Human Services’ Office of Inspector General and the US Department of Justice with more funding in order to investigate healthcare fraud.

The fight against fraud can lead to numerous problems for the ones targeted, including criminal penalties, civil fines, and exclusion from Medicaid and Medicare. Since all physicians’ practices are being watched, even small practices should consider a healthcare compliance program. What does a healthcare compliance plan mean, though? It basically implies a series of internal controls and measures that are taken in order to insure that you are following federal, state and local statutes and regulations that govern the healthcare programs which are federally funded. Most of the time, a healthcare compliance plan includes several components, such as legal reviews of contracts and operating procedures, directives and training for employees, monitoring and auditing mechanisms, and procedures for reporting violations of the healthcare compliance plan or of government regulations. As you can see, a healthcare compliance is to be taken very seriously, since it can prevent your practice from being misconducted.

A healthcare compliance plan can also help you detect and contain misconduct that happens before becoming a bigger issue, such as an investigation conducted by the Office of Inspector General (OIG). Implementing a healthcare compliance program can also reduce the risk of a discontented patient filing a lawsuit against you. This is because every healthcare compliance plan includes mechanisms that allow employees to report problems internally. Additionally, a healthcare compliance program will only come if your favor if or when the government decides to target your practice. Implementing a healthcare compliance program will thus protect you and your practice, since there will be documented efforts of you following the law, which may lead to lighter fines and penalties in case you do make a mistake.

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