Healthcare entities, including providers, organizations, and practitioners must adhere to a complex framework of laws, regulations and standards that govern the healthcare industry. These regulations and standards assure the overall integrity of the healthcare system and support the provision of high-quality, safe healthcare services, and safeguard patient rights and confidentiality. Effective compliance operations help healthcare entities avoid fraud, waste, and abuse concerns.
An effective compliance program incorporates the seven fundamental elements as outlined in the Federal Sentencing Guidelines, is operationalized, and ensures that healthcare organizations and physician practices adhere to the following guidelines:
Compliance programs are mandatory for hospitals, health systems, and physician groups, and the costs of noncompliance is high. They include recoupment of overpayments, self-disclosures, fines, penalties, reputational harm, negative publicity, exclusion from Medicare/Medicaid, and potential individual liability.
We can help your organization with all your regulatory compliance needs.