Simply stated, healthcare compliance means a healthcare practice is demonstrating an absolute commitment to the highest standards of ethics and professionalism, and is following the laws and regulations that pertain to the healthcare industry.
For example, every healthcare practice that files claims under Medicare, Medicaid, and/or private insurance must be following healthcare compliance. These are the guidelines that make sure healthcare organizations do not run afoul of the law by committing Medicare fraud and/or Medicaid fraud, and are being reimbursed properly.
Also, healthcare practices must stay in compliance with security and privacy rules contained within Health Insurance Portability and Accountability Act (HIPAA), and have a protocol in place if data is breached.
For several reasons. Being in compliance and following a program shows your employees and your community that your practice is committed to honesty, ethical behavior and acting responsibly.
It creates a process by which the organization can identify and prevent criminal and unethical conduct, particularly by encouraging your employees to report problems.
By being better able to identify compliance problems — including Anti-Kickback Statute and Stark Law violations — they can be corrected before they are discovered by the government or reported by a whistleblower.
More importantly, without an effective compliance program in place, should health care fraud be identified within your practice, your culpability can be increased. This can lead to allegations of deliberate ignorance and subsequent investigations.
If your healthcare practice does not yet have a compliance program in place, the first thing to do is become familiarized with the OIG Compliance Program Guidelines. It contains seven elements that provide a solid basis upon which an individual or small group physician practices can create a voluntary compliance program:
Because healthcare compliance is complex. There are seemingly endless rules, laws, regulations, and standards on the state and federal levels for healthcare. As a physician or other licensed healthcare professional, your day-to-day practice is hard enough without having to know every nuance of the law and regulations.
At Chapman Law Group, our health care compliance consulting lawyers can advise your practice on how to stay in compliance with state and federal healthcare regulations and the best practices to follow.
Our health care compliance team is made up of highly skilled medical compliance lawyers, Stark Law defense attorneys, and specialists in health care compliance strategies. Our extensive experience in key areas of regulatory compliance in health care include:
Our compliance attorneys have an extensive track record not only as it relates to the operational level of business, but also the regulatory knowledge to advise our clients of the ever-changing federal and state regulatory landscape:
In addition, Chapman Law Group’s healthcare compliance consulting team also addresses all the compliance-related elements of a health care business transaction, including purchasing a facility or practice; embarking on new ventures; selling, merging or closing a practice; and practice governance and recruitment.
Chapman Law Group has 35 years of experience in developing compliance programs and providing consultation for practices nationally.
Our four national healthcare compliance offices are in Detroit, Michigan; Miami and Sarasota, Florida; and Los Angeles/Southern California.
Let us put our experience in health care compliance consulting and program development and implementation to work for you. Contact us today.
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Our attorneys argued to the OIG that exclusion for the prescribed time period was unreasonable under OIG regulations, and that most factors that would lead to a greater exclusion period were inapplicable.
Our attorneys worked with the DEA and negotiated by offering a compliance program to bring the physician back into compliance with the DEA’s requirements.
