Our principal staff has decades of experience in both regulatory and compliance law on both the state and federal levels.
From data security and billing to patient privacy and beyond, we have studied it, worked with it and understand the most up-to-date regulation changes. However, being expert isn’t enough. You also have to explain it to others in terms they can understand.
We’re consultants. We’re trainers. We’re your compliance partners.
State and federal governments have imposed numerous laws and regulations on health care practitioners over the years. With the Affordable Care Act, however, there is an entirely new level of regulatory pressure—more requirements, mandatory compliance and increased penalties and enforcement.
We possess an authoritative understanding in all areas of compliance, including:
The Health Insurance Portability & Accountability Act is a body of federal law that protects the privacy and security of patients’ health information. HIPAA mandates a specific set of requirements for anyone dealing with patient records or information.
The Occupational Safety & Health Administration is the federal agency which enforces workplace safety standards and includes its own specialized compliance requirements.
Stark Law/Anti-Kickback Statutes
Federal and state laws have been created for the prevention of conflicts of interest from illegal referrals and financial relationships. These include their own set of compliance requirements you may not be aware of.
False Claims Act
The False Claims Act is a federal law enacted in 1863 to protect the federal government from fraud and attempts to defraud. It is now applied to fraudulent health care claims made against Medicaid/Medicare.
Fraud, Waste and Abuse (FWA)
Not a section of law but the designation for a broad range of abuses, usually against government agencies. For health care practitioners that file claims with Medicaid or other federal health programs, FWA is also the designation for a broad area of compliance. FWA is investigated and prosecuted under the False Claims Act and similar laws.
Medicare & Medicaid
State and federal governments have established compliance requirements for the health care industry intended to prevent the filing of fraudulent claims for services covered by the programs.
Translating the “Legal-speak”
Certainly, you could track down all the state and federal laws that apply to your particular area of health care practice… if you have hundreds of hours of free time. Then you could study and absorb it all… if you have a law degree, more free time and nearly infinite patience. Then you could work up a compliance program for your practice and get it instituted.
However, because no one has time for even a small fraction of that, we’ve already done all of the “heavy lifting” for you, including:
- Hundreds of hours of thorough review of all codes, laws and regulations
- Identification of the most important points that health care providers must know
- Simplification of government “legal-speak” into plain language
- Preparation of sample compliance programs you can apply to your practice
- Guidance and tips on how to train your staff
- Thousands of tiny details that come from years of compliance experience.
Here to Help
If you are unsure whether you are in compliance, it’s a good chance that you’re not. This also means there’s a good chance your practice is at risk.
We’re here to help.
Let us know if you have any questions at all. Reach out to us through our contact page.