Author Topic: Mandatory Compliance programs for physicians/healthcare offices (AND DENTAL)  (Read 2151 times)

PMRNC

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If you are a billing company and you have clients billing Medicare, Medicaid or any other fed/state benefit plan you want to be sure your clients HAVE or are working on their compliance program which is REQUIRED by March 1, 2013.   Compliance relates to HHS-OIG guidelines on billing, coding, contracts and relationships, partnerships.  The Compliance plan includes approximately 40 policies including the SCREENING of all employee's MONTHLY against the state and federal exclusion databases.

It's probably a good idea to request to see this since we are dealing with billing/coding issues!! Ask them NOW if it's available or if they are working on it! If you are a consultant, it's go time.. $$ :)
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

RichardP

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Is there a name for the requirement/regulation that you are referencing (for search purposes)?  Do you have a link to the document that sets that March 1, 2013 deadline?

PMRNC

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The OIG has had standards out there for physicians and billing companies since the 90's, The Affordable Care Act, however now makes it mandatory. There are a lot of links or you can dig through the ACA  (under physician requirements and specifications). I like this blog : http://www.healthlaw-blog.com/2012/02/mandatory-compliance-plan-requirements-operationalizing-compliance/   but you can find many others.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Christy

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Quote
It's probably a good idea to request to see this since we are dealing with billing/coding issues!! Ask them NOW if it's available or if they are working on it! If you are a consultant, it's go time.. $$



sweet! thanks for the heads up, Linda! ;D

PMRNC

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In reading this further directly from the ACA as written and published in final draft, the MARCH 2013 deadline (3/23/2013) is specific to Skilled nursing facilities..  it does go on to say the mandatory required components of a compliance and ethics program date will be determined by March of 2013.   Sorry everyone.   I've always required my providers / clients to have a compliance plan, policies/procedures and other important things regardless of it now being mandatory so this really wasn't a big deal for me, plus I have no more clients that par with Medicare or Medicaid at all anymore.  I still require them to have one though to address important compliance issues.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

RichardP

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Thank you for the clarification.