Establishing Healthcare Compliance Programs as Mandated by PPACA

The PPACA requires providers enrolled in federal health care programs to implement compliance plans and programs. The Office of the Inspector General (OIG) has identified seven components that every effective compliance program should include. Overpayment reporting, screening of employees and contractors against OIG Lists of Excluded Individuals and Entities, and formal risk assessment measures are among the OIG’s top compliance enforcement priorities. Providers that have not focused their compliance efforts in these areas risk significant penalties.

Health care counsel must guide providers and facilities in implementing compliance programs that meet the PPACA’s fraud, waste and abuse controls, and incorporate the OIG’s core elements. The presentation will discuss best practices for health care providers and facilities to develop compliance plans that will withstand heightened government enforcement and minimize the risk of liability for fraud, waste and abuse. 

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