Compliance: The Next Big Thing

Why This Topic Matters

Healthcare organizations face expanding oversight, audit activity, and documentation expectations. Understanding the scope of compliance programs helps practices prepare for regulatory change, reduce risk, and organize internal controls more effectively.

Article Sections

1. Compliance programs in healthcare

   Introduces the administrative and operational reasons compliance programs are receiving greater attention in healthcare. Discusses their role in practice management and regulatory readiness.

2. Regulatory background and program expectations

   Summarizes the regulatory context behind compliance programs and the broad oversight environment affecting healthcare entities. Covers general program expectations and the agencies involved.

3. Areas a compliance program may address

   Reviews the major categories of rules and oversight commonly considered within a practice compliance effort. Focuses on broad subject areas rather than detailed requirements.

4. Core elements and operational value

   Describes the general components commonly associated with a structured compliance program and the operational benefits practices may seek from them.

5. Monitoring, auditing, and payer oversight

   Covers self-audits, contractor reviews, comparative reports, and related oversight activities that can affect healthcare practices. Emphasizes the general role of monitoring in compliance programs.

6. Building a practice-specific program

   Discusses the need to tailor a compliance program to the individual practice environment and maintain it over time. Addresses implementation as an ongoing operational function.