Implications of model compliance program for interventional pain physicians

W A Sarraille1

  • 1Health Law Group, Arent Fox Klinter Plotkin and Kahn, PLLC, Washington, D.C. 20036, USA. sarailw@arentfox.com

Pain Physician
|August 15, 2006
PubMed

Insights

The Office of the Inspector General (OIG) offers a flexible compliance program for small physician practices. This plan addresses broader risks beyond billing and coding, emphasizing financial relationships.

Area of Science:

  • Healthcare Compliance
  • Physician Practice Management
  • Regulatory Affairs

Background:

  • Small physician practices face resource limitations impacting full compliance program implementation.
  • The Office of the Inspector General (OIG) acknowledges these constraints.
  • Traditional focus on "billing and coding" compliance is insufficient.

Purpose of the Study:

  • To outline the OIG's model compliance program for small physician practices.
  • To highlight the OIG's flexible, step-by-step approach.
  • To identify key risk areas relevant to small practices.

Main Methods:

  • Review of the OIG's model compliance program guidelines.
  • Analysis of suggested implementation steps: auditing, standards, training, communication, discipline.
  • Identification of risk areas, particularly financial relationships with other providers.

Main Results:

  • The OIG program is flexible, recognizing resource limitations in small practices.
  • A step-by-step implementation guide is provided.
  • Risk areas extend beyond billing to include financial ties with suppliers, labs, hospitals, etc.

Conclusions:

  • Small physician practices face increased risk if they do not adopt the OIG's comprehensive compliance plan.
  • The plan broadens the scope of "compliance" to encompass financial relationships.
  • Proactive adoption of the OIG guidelines is crucial for risk mitigation.