Compliance Plan [Healthcare Compliance Tips]

Brush off your compliance plan and increase your knowledge.

I once saw this statement circulating on social media:

Are you really happy or just really comfortable?

It stopped me dead in my tracks.

This statement can apply to different areas of life, but let’s view it from a healthcare compliance perspective.

I know you are thinking, “Joi, what does this have to do with compliance?”

Oh, but it does! As shared in my latest post:

Physicians are less often working in physician-owned practices and more often seeking positions at larger medical practices.

The AMA said 49.1% of its 3,500 national survey respondents were working in private practice as of fall 2020, a drop from the 54% reported in 2018.

I talked to medical practice owners ready to throw in the towel due to feeling like they were stuck in the healthcare conundrum.

After I released the post, I was curious about the other respondents who did not plan to sell their practice.

I asked myself:

What are they doing differently from the other percent?

Do they feel the pressure from the healthcare system?

Are they comfortable with their routines?

Do they apply new regulations to their practice?

I further reflected upon general complacent statements I have heard or read regarding the healthcare field, such as:

“We always do it this way.”

“We haven’t received a letter or audit yet, so we must be doing ok.”

“The practice around the corner does the same thing.”

Unfortunately, the same routine from five years ago will not work today.  Statements such as these will hinder practices from making the necessary changes, forcing them to dive deeper into complacency.

My advice.  Get uncomfortable and upgrade your routine.  Being a little uncomfortable will push your practice to the next level.  Even if everything appears intact, find new ways to challenge your employees and even your patients.

In this series called “Compliant or Complacent: How to Upgrade Your Routine,” I will expand upon my thoughts from “Dear Provider: Don’t Give Up!” and provide additional tips you can enact immediately to upgrade your routine.

Starting with:

Compliance Plan

Since the Affordable Care Act enactment, the U.S. Department of Health and Human Services (HHS) and Office of Inspector General (OIG) state all healthcare providers and suppliers should enact a mandatory compliance plan.

By now, everyone knows this, but most fail to enact all the suggested plan components.

Only sharing HIPAA policies or an OSHA fire escape plan will not cut it in the government’s eyes.

The OIG recommends a “step by step” implementation approach, and it need not be enacted all at once.   However, it must be clear and prove all staff follow it closely, not just letting it lie on the “shelf to collect dust.”

Even though you may not intentionally defraud federal and state programs, lack of knowledge or a compliance plan can lead you right into the abuse category.

To increase your knowledge, you can:

• Visit the OIG website and review the Compliance 101 and Provider Education section.
• Study the “OIG 7 Elements of an Effective Compliance Program” (Federal Register 2000).
• Follow my strategies to reinvent your team, including the “Three E’s.”

As always, use the suggestions above to create a tailored compliance plan that works for everyone.  As you acclimate yourself with the primary functions, it will become easier to spot what you are doing right or wrong within your practice.

Don’t be like other healthcare organizations in the news that were comfortable with old routines. Your goal is to protect your practice from future audits or investigations.

**The opinions and observations from the group/author are not a promise to exempt your practice from fines and penalties.  Research, modify and tailor the advice to fit your specialty.

Click here for the next tip in the series.