When talking about healthcare compliance management programs and their importance, it’s worth going over real world examples that have cause issues for many providers in the past. Consider the physician who for 15 years had his nurse practitioners see his patients and billed the services under his name. He did not intend to commit fraud, but believed he was complying with “incident to billing.” Yet this physician did not qualify because he lacked direct supervision.
In another instance, a physician provided genetic testing. The firm’s marketing team was never trained in CMS rules and signed up people that did not qualify under Medicare guidelines.
Then there was the behavioral services organization that employed licensed and limited licensed mental health workers. The business was purchased by another organization that failed to complete the necessary compliance due diligence before completing the transaction. About a year later the purchasing firm learned that several of the employees never underwent the specific Medicaid background clearance and thus were not eligible to see Medicaid patients.
The minimum cost of these mistakes, with no intent of committing healthcare fraud, is millions of dollars in health care fraud settlements.
Examples of health care fraud are everywhere – all you have to do is scan the headlines.
To support this claim, I found the following headlines searching “healthcare fraud” online while sitting in our Detroit headquarters on July 8, 2025:
These stories represent potentially fraudulent acts, but there are plenty of examples where the healthcare provider did not know their office was not in compliance, such as when engaging in fraudulent billing practices.
A robust compliance program and annual compliance checkups would have caught the internal mistake, saving time, money, and operational stress.
Providers large and small can’t afford not to have a compliance management program, because the consequences of not having one can be devastating. A compliance program is tailored specifically to your needs.
Some organizations develop a program in-house with one or more compliance officers reporting directing to the governance board or CEO. Others only need an initial internal compliance audit and targeted internal policies and procedures with an annual review. The cost of a compliance program depends on the size of the organization and its complexity. The key is making sure that your program is robust and made specifically for you and your practices needs.
Chapman Law Group provides the tools and skills to audit your practice and create a comprehensive compliance program that’s tailored to your specific needs. We will:
After the initial audit we will partner with you to train your staff to periodically audit processes and programs and enforce change when necessary.
Our team collaborates with you to draft policies, procedures and processes that meet your needs. We will be your continuing resource to ensure compliance with state and federal programs.
At Chapman Law Group, we specialize in defending healthcare providers and helping them proactively reduce risk through tailored compliance solutions. Our team understands the unique challenges healthcare professionals face — from unintentional billing errors to regulatory blind spots — and we’re here to guide you with audits, policy development, and long-term compliance support. Whether you’re building a program from scratch or need help fixing gaps before they become liabilities, we provide the legal insight and strategic direction you need to stay protected.
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Ronald W. Chapman Sr., M.P.A., LL.M.
Founding Shareholder
President & CEO
Complex Healthcare Fraud, Qui Tam,
Uninsured Physician Matters, Compliance
All Offices – Main Office Sarasota
6841 Energy Court
Sarasota, FL 34240
Phone: (941) 893-3449
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