OIG Compliance Guidance [Healthcare Compliance Tips]

Study and implement the OIG’s “7 Elements of an Effective Compliance Program” for your industry.

The OIG has developed a series of compliance documents for the following segments of the healthcare industry, such as:

• Nursing Facilities
• Hospitals
• Pharmaceutical Manufacturers
• Ambulance Suppliers
• Individual and Small Group Physician Practices
• Hospices
• DME
• Third-Party Medical Billing Companies
• Clinical Laboratories
• Health Agencies

Compliance programs show that you are making a good-faith effort to protect your practice, patients, employees, etc.  The government wants to see that your focus is to fight fraud and abuse by submitting claims appropriately.

All individual and small group physician practices should:

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.
7. Enforce disciplinary standards through well-publicized guidelines.

Remember, you don’t have to implement all areas at once nor do you have to stop at this list.  But, use this list as a starting point to ensure your compliance program is safe.

**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.