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new york healthcare compliance programs lawyers

Organizing a compliance program for your healthcare practice is the best move you can make. This is an excellent preventative measure that can help your practice avoid lawsuits, accusations of fraud and abuse, and thousands of dollars paid out in ruinous fines. Having a well designed and fully monitored healthcare compliance program will shield you against such claims made against your practice and provide you with state of the art legal protection against such adverse legal judgments. Not only is it entirely advisable to implement a compliance program, it is also required by law.

Why Is It Such A Good Idea To Have A Healthcare Compliance Program?

There are many reasons why it is an excellent idea for your practice to implement a full healthcare compliance program. If you or other individuals representing your practice or business should be convicted of healthcare fraud or some other related offense, the penalties prescribed by the Federal Sentencing Guidelines may be a bit more lenient if you can prove that you have a fully functioning healthcare compliance system in place.

Meanwhile, the Office of the Inspector General (OIG) has recently made it very clear that healthcare providers who do not have a healthcare compliance system will face far harsher penalties if convicted of such crimes or abuses, particularly in OIG-sponsored actions. This means that a company that does not have a compliance system in place may be subject to closure, heavy fines, loss of its owners’ licenses to practice or conduct business in their chosen profession, and even possible jail time.

What Kind Of Businesses Are Required To Have A Compliance Program?

There are many types of businesses that are required by Federal law to have a fully functioning healthcare compliance program in place. These types include, but are not limited to, the following:

  • Hospitals
  • Durable medical equipment manufacturers
  • Home-based healthcare practices
  • Hospices
  • Nursing homes
  • Ambulances
  • Pharmaceutical companies

What Is Contained In The Average Compliance Program?

There are a number of essential elements that will make up the content of the average healthcare compliance program. These elements will usually contain, but may not necessarily be limited to, the following:

  • A designated compliance officer whose task it is to oversee the entire program.
  • Proper facilities and funds for the proper training of program providers.
  • Facilities and funds for the education of employees concerning the program.
  • Programs for internal supervision and auditing in order to ensure full compliance with the program on the part of providers and employees alike.
  • Full provisions in place for any disciplinary action that needs to take place in order to address any lapses in or abuses of the system.
  • A functioning chain of command to ensure that every step of the program is functioning correctly.
  • An open chain of communication in place so that any glitches, oversights, or abuses can be quickly reported and addressed.

An Effective Healthcare Compliance Program Must Be Individually Tailored

It is important to keep in mind that no two practices will ever be exactly the same. Whatever type of business you may own, you can be sure that yours is run differently, and for very likely a whole other set of reasons, than any other in your industry. This means that no two healthcare compliance programs will ever be constituted in exactly the same fashion. As a result, you will need to ensure that your personal healthcare compliance program is fully tailored to meet the needs of your employees.

You Will Need A Healthcare Compliance Program To Participate In Medicare

Your company will need to establish a healthcare compliance program in order to fully qualify to participate in such programs as Medicare, Medicaid, SCHIP, and others. This means that you will need to show proof of a functioning compliance program in order to be considered. If your business is a provider of healthcare services that takes in more than $5 million in annual revenue from Medicare payments, you will need to show proof of a healthcare compliance program. It’s an excellent idea to consult the Internet for further information.

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