This compliance plan covers the seven elements of a small group or third-party billing company’s voluntary compliance plan, as outlined by the U.S. Department of Health and Human Services Office of the Inspector General in 2000.
Voluntary compliance programs are ending. The Patient Protection and Affordable Care Act of 2010 mandates compliance for physicians in order to participate in Medicare. Think of this compliance plan as an investment in your current peace of mind and your practice’s future.
A thoroughly completed and reviewed compliance plan helps a practice organize its approach to compliance issues and focus responses to changes in government regulations.
Policies in the toolkit include:
- Code of conduct
- Compliance officer position description
- Antitrust laws
- DEA certification
- Food and Drug Administration
- Sunshine Act
- Professional courtesy
- Dismissing a patient
- Sexual harassment
- Use of nonphysician providers
- And dozens more
You will need to add further documentation to the customized compliance plan, such as additional policies and procedures documents. At the end of the step-by-step wizard, you will print a hard copy of your compliance plan, and we recommend that you make it available in a central location within your practice.
The provided manual template is not a comprehensive resource for all compliance issues in medical practices.
Limited compliance information is provided on the following laws:
The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
The Occupational Safety and Health Act (OSHA) and related OSHA Standards
Laws, rules and regulations related to employee and human resources matters
Rules and standards related to accurate, comprehensive, and complete coding and billing practices
Our compliance plan toolkit only addresses federal regulations. Please make additional efforts to make your plan compliant with state and other regulations that are applicable to your practice.
Legal review of the Compliance Plan
A legal review of your compliance plan is critical before distribution. Government compliance regulations change over time and regulations may differ from state to state.
Be aware that although the manual template is current as of publication (January, 2015), changes in laws, rules and regulations may require periodic updates to this manual. For instance, supplmental material to the manual includes a summary of the OIG 2015 Workplan. You may access future years' OIG annual workplans, when available, from the OIG web site at http://oig.hhs.gov/. Your practice will need to update the workplan summary regularly.
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