Compliance Programs

Continuing from our last post, this week we are reviewing the topics offered on the HHS OIG website in quick reads. Here are outlines of 5 documents from the OIG website.

HHS-OIG Compliance Training Materials

About OIG’s Training

OIG’s provider compliance training initiative is an outgrowth of the HHS/DOJ Health Care Fraud Prevention and Enforcement Action Team’s (“HEAT”) efforts. In Spring 2011, OIG and its government partners provided training focused on the realities of Medicare and Medicaid fraud and the importance of implementing an effective compliance program. The training focused on a  three-pronged message about provider compliance.

  • Get the Facts. Understand the law and the consequences of violating it.
  • Make a Plan. Cultivate a culture of compliance within your health care organization.
  • Know Where To Go. Learn what to do when a compliance issue arises.

So, you might be thinking “That great. But, what should a compliance program for my organization look like?

There is a lot of information you can pull from searching, and it can be overwhelming.

Let’s look at how a compliance should operate.

The OIG provides a 2-page outline to help you develop and operate a compliance program. Here are the high-level topics the OIG recommends to “operate an effective compliance program.” For details, review the full outline at the following link.

Operating an Effective Compliance Program

  • Review and Update your Policies and Procedures
  • Measure your Program’s Effectiveness
  • Train. Train. Train.
  • Have open lines of Communication
  • Conduct Internal Audits
  • Enforce Policies and Procedures and Promptly Respond to Compliance Issues

Were you aware that your day-to-day efforts for coding compliance was driven in large part to  OIG’s program to fight fraud and abuse?

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