decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Fraud and Abuse / Compliance program elements
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Article Overview
This article summarizes OIG guidance for physician and small group practice compliance programs. It discusses the broad elements commonly used in voluntary compliance plans, implementation considerations for practices of different sizes, and general fraud-and-abuse issues that can arise when obtaining compliance support or training from another entity.
Why This Topic Matters
It helps practices understand the scope of a basic compliance program and the broader compliance environment in which such programs are developed. The article is relevant to physicians, practice managers, and compliance staff who want to evaluate whether their current program structure aligns with widely recognized guidance.
What You Will Learn
- The broad elements commonly included in a physician compliance program
- How compliance program development can vary by practice size and resources
- General considerations when seeking outside compliance training or support
- Why fraud-and-abuse concerns may arise in collaborative compliance arrangements
Who Should Read This
- Physicians
- Small group practices
- Practice managers
- Compliance officers
- Medical billing and coding staff
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