The concept of healthcare compliance programs began in 1997 with a publication by the Office of Inspector General (OIG) within the US Department of Health and Human Services (HHS). That first program was designed for individuals and small group physician practices. Since that time, there have been an entire series of HHS OIG compliance guidelines addressing other segments of the health care industry that includes: nursing facilities, HHS research grants and awards, hospitals, pharmaceutical firms, ambulance providers, hospices, home health agencies, clinical laboratories, third-party medical billing firms, and providers of medical supplies and equipment.
The Affordable Care Act mandated additional …show more content…
Designation of a compliance officer and committee to monitor the efforts and the enforcement of practice standards
3. Institute training and education sessions on compliance procedures, policies, and conduct standards
4. Development of effective communication lines with staff personnel that includes anonymous reporting avenues
5. Use of periodic self-audits to conduct internal monitoring and auditing
6. Enforcement of employee standards using well publicized disciplinary guidelines
7. Prompt response when discovering offenses and the development of corrective action plans
The HHS OIG has published a directory of recommended compliance program guidance documents that can be viewed at http://oig.hhs.org/compliance/compliance-guidance/index.asp.
Healthcare Compliance Program …show more content…
A strong, enforceable compliance program is a positive, protective tool that ensures adherence with all laws and regulations that govern a specific practice. A well-structured program enables a provider to isolate and correct any deficiencies before they can negatively impact a practice. Consultation with a professional, experienced healthcare lawyer will enlighten healthcare providers on the development and implementation of compliance programs that addresses their specific needs and provides them with real protection aimed at minimizing, or eliminating, any potential risks within their particular practices.
A program that is finely tuned and followed is no guarantee that a practice will never be investigated. However, in the event that there is an investigation, having a solid compliance program, with all of the supporting documentation, demonstrates a provider’s commitment to patient safety, violation avoidance, and full adherence to all governing healthcare laws, policies, and regulations. An active compliance program improves the provider’s chances of having a violation viewed as an accidental, one-time, occurrence rather than evidence of a pattern of