BC Advantage - 2017 Issue 3
Getting Serious About Your Practice's Compliance
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Article Overview
This article explains the importance of practice compliance planning for physician organizations, focusing on the role of voluntary compliance programs and the broader oversight environment described by the OIG. It is relevant to practice leaders, compliance officers, administrators, and billing teams who want a high-level understanding of compliance program purpose, organizational responsibilities, and why ongoing monitoring matters. The discussion covers common program components, internal accountability, training, reporting, and the contrast between voluntary compliance efforts and government-imposed oversight.
Why This Topic Matters
Healthcare practices are under increasing pressure to maintain effective compliance processes, reduce billing and reporting problems, and demonstrate good-faith oversight. Understanding the general framework helps organizations assess whether their current compliance efforts are structured, maintained, and aligned with expected standards.
Article Sections
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Voluntary compliance programs and OIG guidance
Introduces the general concept of voluntary compliance programs and the OIG’s emphasis on internal controls and organizational adherence. It frames why practices are encouraged to adopt compliance planning.
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Benefits of a well-designed compliance program
Describes broad operational and oversight advantages associated with having a compliance program in place. The section focuses on general effects for claims processing, billing accuracy, audit risk, and statutory concerns.
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Voluntary programs compared with Corporate Integrity Agreements
Explains the difference between a practice-led compliance effort and a government-imposed oversight arrangement that may arise in enforcement settings. It covers the general circumstances and implications of each approach.
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Building, staffing, and maintaining the compliance plan
Discusses the need for customized policies, staff training, designated leadership, and outside assistance when appropriate. It also addresses ongoing monitoring and regular assessment as part of an active compliance process.
What You Will Learn
- Why compliance planning is emphasized for healthcare practices
- How voluntary compliance programs support internal oversight
- What organizational roles and responsibilities are associated with compliance efforts
- Why ongoing monitoring and employee reporting are important
- How voluntary compliance efforts differ from government-imposed oversight arrangements
Who Should Read This
- Physician practice owners
- Practice administrators
- Compliance officers
- Billing and coding staff
- Healthcare consultants
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