“Health Reform Bill” & New Rules About Medical Compliance

The Patient Protection and Affordable Care Act (Public Law 111-148), also referred to as the “Health Insurance Reform Bill”, is a federal statute that was signed into law by President Barack Obama on March 23, 2010.  This legislation includes a new requirement for an effective compliance program for healthcare organizations.  What was formerly voluntary is now mandatory, including the requirement that healthcare providers applying to enroll as Medicare providers have a compliance program in place.The Office of Inspector General (OIG) of the federal Department of Health and Human Services (HHS) recommends the components of an effective compliance program include:

  • Conducting internal monitoring and auditing
  • Developing and implementing compliance program policies and procedures
  • Designating a compliance officer or contact person
  • Conducting appropriate training and educating of staff
  • Responding appropriately to detected offenses and developing corrective action
  • Developing open lines of communication, and
  • Enforcing disciplinary standards through well-publicized guidelines.

As the Patient Protection and Affordable Care Act is implemented – step by step – regardless of the legal challenges, it is wise to consider the potential impact on your medical practice, including the need for an audit of your medical documentation, coding and billing processes, the program policies and procedures, and the chief compliance officer functions.  All important steps to manage your clinic at best practices benchmark standards.

When you need proven expertise and performance

Dr. Gunter G. Fuchs

Dr. Gunter G. Fuchs has over 30 years of clinical, administrative, consulting, acute care operations, and strategic planning experience in domestic and international healthcare.

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