Compliance Audits and Compliance Program Development

In October of 2000, the Office of Inspector General for Health and Human Services relaesed their guidelines for a voluntary Office Compliance Program.  The Affordable Care Act made Office Compliance Programs mandatory as a condition of enrollment in Medicare.

An effective compliance program ensures that your office is complying with:

  • CMS
  • OIG
  • HIPAA (Privacy & Security)
  • OSHA
  • CLIA
  • Stark Laws (I, II, & III)
  • Anti-kickback Laws

Virtually every federal agency and the federal sentencing guidelines consider the existence of an effective compliance program as a mitigating factor in the imposition of fines and civil money penalties.  But the compliance program must be in place before the doctor is investigated!

To be an effective compliance program it must be custom developed for your office.  The development of an effective compliance program involves:

  • Specialized questionnaires sent to you and your staff
  • An on-site inspection of the facility
  • Review of OSHA manual and exposure plan
  • Review of HIPAA manual and procedures
  • Review of office procedure, policies and job descriptions
  • Accounts Receivable analysis
  • A chart audit of randomly selected records (10 per doctor)
  • Claim reviews of selected records
  • EOB reviews of the selected records
  • Review of marketing for compliance with Federal anti-kickback laws
  • Review of agreements for compliance with Stark laws

As a result you will receive:

  • A list of practice deficiencies and recommended corrective actions
  • A list of documentation deficiencies and recommended corrective actions
  • Personalized compliance manual with optional training available for all staff
  • 30 days of telephone support
  • Complete confidentiality
  • Peace of mind
  • And More

To learn more about the Office Compliance Program view the free webinar here.

To obtain a quote for a Compliance Audit and Office Compliance Program for your office call Dr. Short at 217-285-2300