Heads-up, Medicare and Medicaid providers: You are strongly encouraged to develop and implement an Affordable Care Act compliance program in anticipation of the Department of Health and Human Services' release of guidance documents, which will likely be issued soon.
The Patient Protection and Affordable Care Act of 2010 mandates that all health care entities and providers participating in federal health care programs, including individual and small-group physician practices, implement effective compliance programs to prevent, detect and correct violations of federal health care laws and regulations.
To begin now, providers can consult the HHS 2010 guidance documents, which establishes seven core elements to be included in a compliance program for individual or small-group physician practices:
- Conducting internal monitoring;
- Implementing compliance and practice standards;
- Designating a compliance officer or contact person;
- Conducting appropriate training and education;
- Responding appropriately to detected offenses and developing corrective action;
- Developing open lines of communication; and
- Enforcing disciplinary standards through well-publicized guidelines.
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