tci Medicare Compliance & Reimbursement - 2021 Issue Q1
Compliance: Don’t Shirk on Compliance Planning
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Article Overview
This article discusses why compliance planning remains important for healthcare practices and outlines broad areas commonly included in an effective compliance program. It focuses on general planning themes such as laws and regulations, staff training, clear policy language, defining misconduct, and maintaining an internal checklist, with attention to current enforcement and pandemic-era operational concerns. The piece is aimed at practice administrators, coders, compliance professionals, and clinicians who help support policy and training efforts.
Why This Topic Matters
Healthcare organizations face ongoing audit and enforcement risk, and this article explains why proactive compliance planning can help practices prepare. It is relevant for teams updating policies, training staff, and reviewing internal processes during a period of heightened scrutiny and operational strain.
Article Sections
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Incorporate These 5 Components
Introduces broad elements commonly addressed in compliance planning, including legal awareness, training, policy clarity, misconduct definitions, and internal tracking of obligations. It also references current enforcement attention and pandemic-era operational issues.
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Self-Audit Your Compliance
Covers self-assessment and outside review of compliance plans, including the role of internal stakeholders and committees. It emphasizes evaluating whether a plan is current, understandable, and internally consistent.
What You Will Learn
- Why compliance planning remains important during periods of enforcement activity and operational disruption
- What broad components are commonly included in a healthcare compliance program
- How training, policy language, and misconduct definitions support compliance efforts
- Why self-audits and external review can help strengthen a compliance plan
Who Should Read This
- Healthcare practice administrators
- Compliance officers
- Medical coders and auditors
- Physicians and clinicians
- Revenue cycle and billing staff
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