decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Compliance / Value and fundamental principles of compliance programs
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Article Overview
This article explains the Office of Inspector General’s general model compliance plan for physician practices and how its principles can extend to certain other independent practitioners. It is aimed at practices that want to understand the broad structure and purpose of compliance programs, including ethics, leadership, internal coordination, and alignment with federal, state, and payer requirements. The discussion is high-level and focuses on practical program objectives rather than specific coding or billing instructions.
Why This Topic Matters
Compliance programs help practices reduce risk, support ethical operations, and organize internal oversight of legal and payer requirements. Understanding the OIG’s framework is important for practices seeking to evaluate whether their compliance efforts are appropriate for their size, structure, and services.
What You Will Learn
- The general purpose of a physician practice compliance program
- How OIG frames compliance expectations for different types of practices and practitioners
- The role of ethical leadership and organizational culture in compliance
- How compliance programs support coordination of policies, guidance, and internal oversight
- Why compliance programs can contribute to quality, appropriateness, and waste reduction
Who Should Read This
- Physician practices
- Independent practitioners
- Practice managers
- Compliance officers
- Healthcare administrators
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