Compliance

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Under the Affordable Care Act, compliance programs are mandatory for all health care providers who accept any federal health care payments (Medicare, Medicaid, Tricare, etc.).

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Acevedo Consulting can:

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• Develop your Code of Conduct and Compliance Plan

• Conduct your "kick off" and annual compliance training

• Provide support for your compliance staff

• Conduct chart reviews

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The OIG believes that every compliance program should begin with a commitment to address the seven elements of an "effective" Compliance Program. Based on the seven elements set form in the Federal Sentencing Guidelines, defined as:

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1. Establishing compliance standards through the development of a code of conduct and written policies and procedures.

2. Assigning compliance monitoring efforts to a designated compliance officer or contact who reports to the governing authority.

3. Conducting comprehensive training and education on practice ethics and policies and procedures.

4. Conducting internal monitoring and auditing, focusing on high-risk billing and coding issues through performance of periodic audits and risk assessments.

5. Developing accessible lines of communication, such as discussions at staff meetings regarding fraudulent or erroneous conduct issues and community bulletin boards, to keep practice employees updated regarding compliance activities.

6. Enforcing disciplinary standards and ensuring employees are aware that compliance is treated seriously and that violations will be dealt with consistently and uniformly.

7. Responding appropriately to detected violations through the investigation of allegations and the disclosure of incidents to appropriate Government entities when appropriate.