Medical practices need to be prepared for all healthcare compliance issues. Compliance means staying out of harm’s way from liability risk and government scrutiny. Organizations must be diligent in observing guidelines, medical coding regulations, and state and federal laws for proper submissions of claims and rules including: False Claims Act (Civil), Healthcare Fraud Statute (Criminal) ,Anti-kickback Statute, Stark Law, Active Labor Act, Emergency Medical Treatment (EMTALA), Occupational Safety and Health Administration (OSHA) guidelines, and HIPAA Privacy and Security rules.
DoctorsManagement professionals understand the complexities of compliance and the regulatory landscape and can provide compliance managers with cost-effective services to help proactively protect your organization and maintain compliance from initial compliance program planning to day-to-day guidance. We understand that meeting hundreds of compliance requirements can be stressful, and we are here to support you.
- Coding & Audit
- OSHA Compliance
- OSHA Seminars
- HIPAA Compliance
- Laboratory Compliance (CLIA)
- Assessing Your Medicare Risk
- Provider & Staff Training
Medical practices must comply with Federal Trade Commission (FTC) and Federal Drug Administration (FDA) rules and regulations. The Patient Protection and Affordable Care Act requires physicians to have a compliance plan in place for doctors who treat patients on Medicare or Medicaid. DoctorsManagement has experienced healthcare compliance specialists that are skilled at legal issues involved with the complexities of healthcare compliance.
With the passage of the Patient Protection and Affordable Care Act of 2010, physicians who treat Medicare and Medicaid beneficiaries will be required to establish a compliance program
The Office of Inspector General (OIG) recommends that Individual and small group practices incorporate the following into their voluntary compliance plan to:
- Designate a compliance officer or contact
- Implement compliance and practice standards
- Respond appropriately to detected offenses and develop corrective action
- Conduct appropriate training and education
- Develop open lines of communication
- Conduct internal monitoring and auditing
- Enforce disciplinary standards
- Risk Assessment
There should be an assessment of known risk areas. Common risk areas the OIG recommends medical practices focus on include:
- Possible coding and billing risks
- Improper inducements, kickbacks and self-referrals risks
- Documentation risks
- Reasonable and necessary services risks
Create a Compliance Plan
DoctorsManagement compliance specialists are experts at assisting organizations in defining and creating a regulatory compliance plan that helps your medical practice get paid for reasonable and necessary service and focuses on meeting self-referral, HIPAA, OSHA, anti-kickback laws, fee splitting, and other regulatory challenges that a practice requires.