BC Advantage - 2019 Issue 8
OIG Compliance 101 - Ensuring the Next Generation is Prepared
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Article Overview
This article explains the broad framework of Office of Inspector General compliance expectations for health care providers and suppliers, including the seven fundamental compliance elements, an additional risk assessment focus, and practical ways to strengthen a culture of compliance. It is aimed at health care compliance professionals, practice leaders, auditors, and administrators who want a high-level understanding of compliance program structure, oversight, and risk awareness. The article also highlights general compliance risk areas and major fraud-and-abuse topics referenced in provider compliance discussions.
Why This Topic Matters
Compliance programs are central to organizational readiness, risk reduction, and meeting federal health care program expectations. This article helps readers understand the major components of an effective program and the types of oversight issues that commonly draw attention.
Article Sections
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The Seven Fundamental Elements of an Effective Compliance Program
Introduces the core framework for an effective compliance program and discusses each of the principal operational areas at a high level.
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Five Practical Tips for Creating a Culture of Compliance
Summarizes practical compliance culture considerations for organizations, including risk awareness, relationships, and when to seek outside help.
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What to do next…
Provides closing contact and service information for readers who need further assistance with compliance or audit-related concerns.
What You Will Learn
- The general structure of an effective health care compliance program
- Why compliance oversight and culture matter for providers and suppliers
- How risk assessment fits into a compliance framework
- Broad categories of compliance risk areas commonly monitored in health care organizations
- The role of monitoring, training, communication, and corrective action in compliance programs
Who Should Read This
- Health care compliance officers
- Practice administrators
- Physician leaders
- Medical auditors
- Billing and coding staff
- Health care consultants
Codes Discussed
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