decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
OIG Model Compliance Plan / Compliance Plan Elements
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Article Overview
This article explains the Office of Inspector General’s overview of compliance program fundamentals for health care organizations. It is aimed at providers, practices, and billing-related entities that want a high-level understanding of how compliance programs are typically structured, how implementation may vary by organization size and resources, and why collaboration with other entities can raise broader fraud-and-abuse concerns. The discussion stays focused on general compliance program development and related legal caution areas.
Why This Topic Matters
A clear grasp of these compliance program elements helps health care organizations evaluate whether their internal processes support a structured compliance effort and identify when outside assistance or shared resources may raise additional regulatory issues.
Article Sections
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Compliance program basics
Introduces the overall purpose of a voluntary compliance program and frames the article’s focus on foundational program components. It provides context for organizations evaluating compliance readiness.
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Implementation considerations by organization size
Discusses how the extent of compliance program implementation may differ based on available resources and organizational scale. It also notes that different models may be used to fit different practice environments.
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Collaborative development and related concerns
Covers broader guidance on using training, templates, or assistance from other entities when developing a compliance program. It also addresses general caution areas involving fraud-and-abuse considerations.
What You Will Learn
- The general elements commonly associated with a voluntary health care compliance program
- How compliance program implementation can vary by organization size and resources
- Why collaborative compliance program development may require attention to broader regulatory concerns
- What types of organizations may find this guidance relevant
Who Should Read This
- Health care providers
- Medical practice administrators
- Compliance officers
- Billing and coding professionals
- Revenue cycle staff
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