Regulatory compliance can seem like a never-ending ball of red tape for many Dallas healthcare service providers. The purpose of a compliance plan is not to drive you crazy. It’s to correct existing problems before they get out of hand and prevent new problems from developing in the future. A sound compliance plan can protect you, your medical practice, or your healthcare entity from the sometimes devastating consequences of non-compliance.
Developing and implementing a strong compliance program can be difficult for today’s healthcare service providers. The easiest way to avoid confusion and ensure that your compliance program is doing what it should is to retain a Dallas healthcare compliance attorney. Texas healthcare compliance attorneys Raiser & Kenniff have the experience and the knowledge to help you maintain an effective compliance program and keep it up to date. We can also develop and implement a new healthcare compliance plan that best suits the needs of your healthcare organization.
A Dallas Healthcare Attorney Can Keep You On The Right Side Of The Law
Your lawyer will conduct an initial risk assessment of your medical practice or healthcare entity to identify potential problems and weak links. He or she will then reduce these risks by creating a compliance program that conforms to the requirements of Medicare and third-party payors by way of practical procedures, clear policies and ongoing education.
Is Compliance Voluntary?
In most cases, healthcare compliance programs are encouraged rather than required. However, having a voluntary compliance plan in place will always reflect favorably on you, your medical practice or your healthcare organization in the event that you are audited or investigated. Although today’s compliance programs are still mostly voluntary, the trend is for these programs to become compulsory going forward.
Recent healthcare reform legislation now requires that the Department of Health and Human Services (DHSS) make compliance programs a requirement for certain types of healthcare service providers. In 2010, the Affordable Care Act required compliance programs for Medicare and Medicaid service providers. Medicaid service providers that receive more than five million dollars annually are required by law to have written policies related to fraud.
Where Did Healthcare Compliance Programs Come From?
In 1997, the Office of the Inspector General (OIG) released the first healthcare compliance publication in association with the DHSS. That initial program was aimed at single practicing physicians and small groups of practicing physicians. However, the release of that first document led to additional DHHS OIG compliance documents aimed at other participants and entities within the healthcare industry. Those entities include home healthcare agencies, nursing facilities, hospitals, rehabilitation facilities, pharmacies, hospices, medical equipment suppliers, clinics and medical laboratories.
What Do Compliance Plans Include?
The 2010 OID compliance guidelines are used as a basis for today’s compliance plans. Compliance programs have seven essential elements:
1. Training and education
2. A compliance officer and a compliance committee
3. Monitoring and internal auditing
4. Implementing policies, procedures and standards of conduct
5. Enforcing employee standards and conducting disciplinary procedures
6. Responding quickly to offenses and taking corrective action
7. Establishing clear communication with staff personnel
The healthcare compliance attorneys at Raiser & Kenniff will identify any elements of your practice or healthcare entity that require attention. We will communicate with key personnel to determine how your services are provided, recorded and billed. This will help us understand the systems and procedures currently in place. We will also review third-party payor policies as well as OIG compliance guidelines related to risks and fraud alerts.
Next, we will develop a compliance policy draft based on what we discovered during our assessment. The new policy will be designed to help you improve and maintain compliance within your practice or healthcare entity. After the draft has been finalized, we will implement the plan and educate your staff on how to best comply with it. The result is consistency throughout the service delivery process. After the plan is implemented, we will monitor it to make sure that the new policies are being followed and that the policies are being updated according to changes in the law.
Representation In All Areas Of Healthcare Compliance
Becoming and remaining compliant is essential for successful Dallas healthcare delivery. Given the penalties and negative consequences of non-compliance, retaining experienced legal counsel is one of the best investments you can make in your practice or healthcare entity. To learn more about how the experienced compliance attorneys at Raiser & Kenniff can help you to become fully compliant, call 888-533-5131 for a risk-free consultation.