Medicare Compliance & Reimbursement

Compliance plans can make all the difference - here's how to get started.

In its 2005 work plan, the HHS Office of Inspector General (OIG) underscored voluntary compliance plans as a key way to root out fraud. So read on to ensure your practice is up to the challenge.

Voluntary compliance plans are not as scary as they sound, says Kristine Eckis, CPC, CMM, president of the Bottom Line Medical Administrative Consultants, Inc.

What physicians can do: Following the OIG recommendations for a voluntary plan can be painless. According to Eckis, here's the set-up in a nutshell: 

1.  Conduct internal chart auditing. In the last couple of years, this has become the OIG's No. 1 recommendation.

2.  Implement compliance and practice standards. A physician's plan should simply state what her practice does and believes, Eckis says.

3.  Designate a compliance officer (CO) and conduct appropriate training and education. A physician can get the office manager or fellow physician to fill the role, Eckis suggests.

4.  Respond to offenses and develop corrective action. Have a locked box somewhere where employees and staff can report potential problems to the CO. But make sure the compliance plan allows immunity from any type of disciplinary action for the whistleblower. 

Lesson learned: Adopting a voluntary compliance program could safeguard a physician practice if Medicare auditors come knocking.