decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Physician Practice Model Compliance Plan / Compliance Tips and Tools / Frequantly Asked Questions
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Article Overview
This article is a practical FAQ for physician practices that are building or refining a compliance program. It explains the kinds of issues practices are expected to think about, how compliance functions can be organized, and what broad federal guidance addresses fraud, abuse, reporting, discipline, and exclusion-related concerns. It is aimed at physicians, practice managers, billing staff, and compliance personnel who need a general orientation to compliance planning.
Why This Topic Matters
Physician practices must understand the compliance environment to reduce risk, respond appropriately to suspected problems, and maintain alignment with federal oversight expectations. This article helps readers gauge whether they need deeper guidance on practice auditing, staff training, response processes, and related enforcement topics.
Article Sections
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Frequently Asked Questions
Introduces the article as a question-and-answer discussion of physician practice compliance topics and federal oversight considerations.
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Compliance program implementation and risk areas
Covers broad issues involved in building a physician practice compliance plan, including phased implementation, audit and monitoring priorities, and major risk categories identified by oversight guidance.
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Outsourcing compliance functions and staff training
Discusses general options for delegating compliance-related responsibilities and the broad formats that can be used for staff education and communication.
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Responding to suspected violations and maintaining communication
Addresses the need for corrective action processes, internal reporting, open communication practices, and disciplinary approaches when compliance concerns arise.
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Federal fraud penalties and exclusion resources
Summarizes the article’s discussion of federal enforcement consequences and references to public exclusion resources maintained by government agencies.
What You Will Learn
- How physician practice compliance plans are discussed in a FAQ format
- What broad compliance risk areas are highlighted for physician practices
- What general approaches are mentioned for compliance staffing and training
- How practices are encouraged to respond to suspected noncompliance
- What kinds of federal oversight and exclusion resources are referenced
Who Should Read This
- Physicians
- Medical practice managers
- Billing staff
- Compliance officers
- Healthcare administrators
Codes Discussed
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