Health Care Providers Must Comply with Complex Laws
As a medical provider, you work within a highly complex web of federal and state regulations. Some of these regulations include:
- The Health Insurance Portability and Accountability Act (HIPAA)
- Stark Law
- Anti-kickback Statutes (Federal and State)
- The False Claims Act, and
- licensing and general business laws
Given this complex environment, healthcare providers can get hit with substantial fines and penalties when the government investigates for noncompliance. For instance, in 2010 the federal government recovered $4.1 billion in fines and penalties for noncompliance with health laws. And that amount has increased each year. The government has reported that they have collected $7.20 for each $1 spent in these investigations. In other words, when the government investigates for compliance, they are very successful in finding reasons to penalize.
Law for Doctors Attorneys can help you Develop a Health Care Compliance Program
It’s best to prepare for the inevitable compliance investigation or audit of your practice before the investigation occurs. Law for Doctors can help you review or develop your compliance program so you can be ready.
What is a Compliance Program?
A compliance program essentially tells your organization, your patients, the public, and the government that your practice is dedicated to adhering to applicable federal and state laws and that your organization respects federal and private healthcare dollars. We cannot overemphasize the benefits of establishing an effective and active compliance program. An effective and active compliance program is one that actually helps you prevent instances of noncompliance and one that helps you monitor and enforce the policies, systems, and procedures put in place to help your organization conform to applicable federal and state laws. It is not a document in a binder collecting dust on a shelf.
The federal government has recognized that “there is no ‘one size fits all’ compliance program” for all healthcare entities. You can tailor your healthcare compliance program to fit your organization. The healthcare compliance attorneys at Faux Law Group can help you develop a compliance program that is right for your business and budget.
Why Have a Compliance Program?
A compliance program will help you avoid the costly and potentially devastating consequences of noncompliance. These consequences can include:
- Fines and penalties. Fines for noncompliance can be $50,000 per incident of noncompliance or can be triple any damages caused to federal health programs. As repeatedly seen on the news, these fines can result in millions of dollars of losses to healthcare entities.
- Exclusion from federal programs. Facilities, doctors, and even business administrators can be entirely excluded from participating in federal health programs, such as Medicare and Medicaid. Exclusion from these programs can seriously jeopardize your business’ viability and can compromise your ability to find meaningful employment in the healthcare sector.
- Incarceration/Jail. In some instances, failure to comply with healthcare regulations can result in criminal charges. If you willfully neglect to address compliance issues, you may be putting your very freedom at risk.
A compliance program will help you avoid these consequences. When your office is investigated for compliance–and this is a matter of when and not if—having an active compliance program can mitigate damages or help you avoid incurring penalties all together.
Challenges in Establishing A Compliance Program
A top OIG official has reportedly said that a healthcare organization can either pay the costs associated with compliance on the front end, or it can pay on the back end. The main difference is that the front end costs are substantially less than the back end costs. That being said, we certainly acknowledge that there are costs and other challenges to implementing an effective and active compliance program.
Law for Doctors can Help!
The healthcare compliance attorneys at Law for Doctors have developed solutions to help you overcome the challenges to compliance. Your organization will benefit from having legal counsel assist you in preparing an effective compliance program. Contact us to learn more about how the health care compliance lawyers at Law for Doctors can help your organization.