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Health Care Compliance Programs

Health Care mandatory compliance programsCompliance Programs In Stamford, Greenwich, Norwalk And Fairfield, Connecticut

Is your mandatory compliance program up and running?

Are you ready to implement your mandatory compliance program according to the Affordable Care Act requirements?

Does your compliance program meet the effective compliance program standards of the federal Office of the Inspector General (OIG) as well as any standards required in your state?

How Will The Affordable Care Act Affect My Practice?

The Patient Protection and Affordable Care Act (PPACA) also known as The Affordable Care Act (ACA), provided the authority to the Secretary of Health and Human Services (HHS) to compel health care providers and suppliers to implement compliance programs as a condition of enrollment in Medicare, Medicaid and the Children's Health Insurance Program [Section 6401 of the Patient Protection and Affordable Care Act. Pub. L. 111-48 (2010)].

Establishing an effective compliance program has become a requirement in order to participate as a provider in the U.S. health care industry. Several changes in the health care landscape have contributed to its growth. The Federal Sentencing Guidelines ("Guidelines") established the initial foundation for health care compliance (see Section Eight of the Guidelines).

In addition, the OIG has moved aggressively to encourage providers of all types to implement compliance programs and has issued Model Guidance Plans that are specific to certain specialties of care within the health care industry. It has identified seven components that every effective compliance program should include:

  1. Compliance Standards and Procedures
  2. High-Level Responsibility
  3. Employee Screening
  4. Educational Programs
  5. Monitoring and Auditing
  6. Discipline and Enforcement
  7. Response and Prevention

There may be additional requirements depending on the state in which you do business. Overpayment reporting, formal risk assessment measures, and screening of employees and contractors against the OIG List of Excluded Individuals/Entities (LEIE) are among the OIG's top compliance enforcement priorities. Providers that have not focused their compliance efforts in these areas risk significant penalties.

Which Key Target Area Is The OIG Focusing On For My Practice?

The HHS OIG Work Plan for Fiscal Year 2013 provides brief descriptions of targeted activities that OIG plans to initiate or continue to focus on in fiscal year 2013. The Work Plan describes the primary audit and inspection focal points for the various sectors of health care providers including:

  • Hospitals
  • Hospice care
  • Home health care services
  • Nursing homes
  • Medical equipment and supplies
  • Ambulatory surgery centers
  • Behavioral health clinics
  • Ophthalmologists
  • Sleep centers
  • Other health services

Risk Mitigation. Robust Compliance. Solid Defense.

Beltrano Law knows regulatory compliance in the health care industry. Let regulatory compliance attorney Michelle Beltrano and her team provide the legal guidance and compliance program expertise that is required to navigate today's tough enforcement culture.

"Not all health care businesses are the same and they should not be treated the same when it comes to developing a compliance plan. We can develop an individualized compliance program that fits the size and scope of your health care business and we will make sure it fits your budgetary requirements. In addition, as part of the program we can develop an internal risk assessment tool that you can easily manage and utilize throughout your practice." — Attorney Michelle Beltrano

Contact An Experienced Greenwich Health Care Compliance Attorney

Beltrano Law seeks to help independent health care providers balance excellence in patient care with effective practice management so as to drive continued profitability and sustainability.To determine how best to manage your practice in light of new health care regulations, contact Beltrano Law at 203-340-2610 for more information on how we can help you.

mandatory compliance programs

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