decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Fraud and Abuse / Benefits of a compliance program
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Article Overview
This premium article discusses the benefits of a voluntary compliance program in a physician practice and the general fraud-and-abuse context behind that guidance. It is aimed at practices, compliance staff, and coding or billing professionals who want to understand the broad reasons OIG supports compliance efforts, the kinds of operational benefits a program may provide, and the cautions OIG places around using model guidance. The article also touches on related oversight themes involving federal and state laws, private health plan rules, and the role of legal counsel.
Why This Topic Matters
Compliance programs can affect patient care, billing accuracy, audit risk, and a practice’s response to fraud-and-abuse concerns. Understanding the scope of the OIG discussion helps organizations assess whether the article is relevant to compliance planning and internal policy development.
What You Will Learn
- Why OIG views compliance programs as relevant to physician practices
- The broad operational and compliance benefits associated with a voluntary program
- The role of documentation, reporting, and corrective action in a compliance framework
- The general cautions OIG includes about using model compliance guidance
Who Should Read This
- Physician practices
- Compliance officers
- Billing and coding staff
- Practice managers
- Healthcare administrators
- Healthcare attorneys
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