A healthcare practitioner may ask him/herself why he/she needs a Compliance Program and a Compliance Attorney. That is a fair question and there are many reasons why a physician, healthcare provider, healthcare practitioner should have both.
First, the Affordable Care Act has made it mandatory for all Medicare healthcare providers to have a Compliance Program and while the regulations have not universally been put into place, they may be imposed upon a physician or other provider by various government entities, sooner than you think. When that happens, the provider and/or physician will not have the leisure of implementing such a program over a period of time, but, rather have to initiate one with little or no preparation time. A good Compliance Attorney can help a physician or other healthcare provider or practitioner initiate a good Compliance Program now, while he/she have time to ascertain how such a Compliance Program can be best tailored to the physician’s or provider’s practice needs.
Second, a good Compliance Program will permit a physician or healthcare provider to maximize his/her billings while minimizing the exposure to government sanctions. A good Compliance Program will help assure proper coding and documentation. A physician or other healthcare provider can undertake all of the procedures this is required to render a service but if it is not properly documented with the changing rules and requirements, the physician or healthcare provider could end up having to repay the government when audited by a Recovery Audit Contractor [RAC] or a Zone Program Integrity Contractor [ZPIC].
A RAC is a bounty hunter that literally makes its money by imposing denials upon healthcare providers. How much cause do you think it takes for them to retroactively deny a physician’s payments and withhold ongoing and future payments to make up for those ill-imposed denials? Not Much. A ZPIC may also impose denials but also takes the time to report you for further adverse action by such agencies as the FBI or Office of Inspector General [OIG] of HHS. The ZPIC personnel think that they are the OIG or FBI but they have none of the training or professionalism. A good Compliance Program and good Compliance Attorney can stand up for a physician, healthcare provider, and/or healthcare practitioner and help protect them from these threats from RACs and ZPICs. As far as a fair audit, the RAC attack, RAC audit is the least fair, closely followed by the ZPIC audit. A good Compliance Program and good
Compliance Attorney can help protect you.
Third, a good Compliance Program helps protect the physician, healthcare provider, and healthcare practitioner from deceit and deception perpetrated upon them by their staff or their private contractors with whom they do business. Staff can file a False Claims Act complaint against you, take you money and destroy your practice or business. The staff or private contractors can even be responsible for the errors and report you. Business associates can try to sell you a scheme to make them rich and you under investigation. Physicians, healthcare providers and healthcare practitioners need protection. A good Compliance Program with a good Compliance Attorney can help create such protection.
The heart of a good Compliance Program is a good, experienced Compliance Attorney. A good experienced Compliance Attorney can help protect physicians, healthcare providers and healthcare practitioners in these and many other ways. Mr. Kenneth Haber is a former Assistant United States Attorney and a former Senior Attorney in the Office of Inspector General (OIG HHS). Additionally, he is a former Priority Security Asset of the FBI. You are not going to find anyone with those credentials and Mr. Haber’s, rather, unique experiences elsewhere. He is experienced in and out of government. He is experienced in Medicare and private pay issues. He is experienced in Licensing Board matters and hospital staff privileges. He is experienced in US District and Courts of Appeal as well as administrative agencies. He is experienced in criminal aspects of Medicare as well as administrative aspects of Medicare and much more. He has over 40 years of experience. He is ready to stand up for you and protect you. Call for an initial no obligation consultation and see how we can help you. . .