Avoiding Healthcare Fraud, Waste and Abuse
Health care reform and the Affordable Care Act, also known as Obama Care, require all providers to have a written compliance program (fraud, waste and abuse) in place. You are required to train your staff within 90 days of employment and every year thereafter.
NOTICE: To be completely clear, if Medicare requires it, all other state and private-payer programs do ALSO. Follow the Medicare guides on compliance, fraud, waste and abuse (FWA) at all times.
Are you compliant?
Compliance Programs For Physicians
Establishing and following a compliance program will help physicians avoid fraudulent activities and ensure that they submit true and accurate claims.
The following seven components provide a solid basis upon which a physician practice can create a voluntary compliance program:
1. Conduct internal monitoring and auditing;
2. Implement compliance and practice standards;
3. Designate a compliance officer or contact;
4. Conduct appropriate training and education;
5. Respond appropriately to detected offenses and develop corrective action;
6. Develop open lines of communication with employees; and
7. Enforce disciplinary standards through well-publicized guidelines
Section 6401(a)(7) of the Affordable Care Act requires physicians who treat Medicare beneficiaries to establish a compliance program
To read more: Avoiding Fraud, Waste and Abuse