Developing & Implementing a Compliance Program for Your Agency

Fraud, waste, and abuse, oh my! The healthcare industry is awash with reports of providers under investigation for suspected fraudulent billing practices. From fines in the millions to possible prison time, the consequences for healthcare fraud are significant. Even the most ethical business owners are at risk if employees are not adequately trained and monitored. The development of an effective compliance program is essential to ensure that federal, state, payer and company requirements are abided by staff. In this presentation, we will begin by exploring relevant regulatory rules and the seven essential elements of a compliance program identified by the OIGs. We’ll discuss the process of creating an agency-wide compliance program, including designating and training a Compliance Officer, documenting policies, training staff, building infrastructure to support monitoring plans, and general oversight.