OIG Recommends Steps for Compliance by Health Care Governing Boards

The U.S. Department of Health and Human Service’s Office of the Inspector General (OIG) recently provided health care governing boards with some new points of guidance on how to achieve high levels of compliance throughout their organizations. With federal agencies cracking down on fraud now more than ever, it’s important for these governing boards to understand and adhere to best practices.

The following are a few of the recommendations OIG has made:

• Clearly define the jobs of your compliance, audit and legal departments. OIG states that health care leaders must be able to create clear and distinct responsibilities for each department, along with boundaries they are not allowed to cross. These departments should also have a thorough understanding of the role they play in the overall compliance process, and know they may communicate with each other regularly to ensure a stronger organization.
• Review and assess the protocols in place for reporting issues and gathering information. Hospital boards should mandate every compliance-related sector to report on all of its risk management and compliance efforts independently. The boards should then measure how each sector implements compliance programs, deals with risks and takes corrective actions.
• If you discover potential risk areas, conduct audits. These types of risk areas could be vulnerabilities in your health care systems, such as privacy breaches or billing problems. Conducting regular audits can help identify these risk areas so that you can take corrective action right away.
• Do everything you can to encourage organization-wide compliance. Engage in regular performance assessments and award bonuses to the departments that meet their standards. Take the initiative to self-report any compliance violations if they are discovered.

For further health care compliance tips, speak with an experienced New Jersey attorney at Buttaci Leardi & Werner, LLC.

Tagged with: compliance, fraud, health care, OIG

• Posted on: Jun 30 2015