Implement a Compliance Plan Before It's Too Late!

In this era of heightened scrutiny of health care practices, every provider of health care services or products (ie, medical practices, clinical laboratories, billing companies, durable medical equipment suppliers, etc.) must implement compliance plans to educate their employees to avoid questionable billing practices before they become the subject of government criminal or civil investigations or lawsuits. A voluntary and comprehensive compliance plan that addresses issues such as medical record documentation, billing, privacy and confidentiality, and fraud and abuse – which is implemented and complied with – may reduce the chances of an audit and minimize the criminal or civil liability of the practice or its principals in the event a problem arises. Under the sentencing guidelines issued by the U.S. Sentencing Commission, the sanctions that may be imposed for violations of the law may be reduced if the organization had an effective and meaningful compliance program in place before the bad conduct occurred. Therefore, even if the program failed to prevent and detect the illegal conduct, if the organization had in good faith taken reasonable steps to prevent such conduct from occurring, the criminal fines or other sanctions may be minimized.