The BAA – How to Do It Right!
7 Compliance Best Practices Every Leader Should Know
The BAA – How to Do It Right!
7 Compliance Best Practices Every Leader Should Know

5 Tactics to Combat Healthcare Fraud

In this series, I shared that the government recovered five billion dollars from the healthcare False Claims Act in 2021, one of the most significant recoveries in the history of healthcare.

Leaders, if you don’t want to be next on their list, it’s time to enact a compliance program that helps:

#7: Combat healthcare fraud, waste, and abuse.

You are not alone in this fight.  

The OIG has created a five-principle strategy to show they are doing their part, which includes:

  • Enrollment: Scrutinize individuals and entities that want to participate as providers and suppliers prior to their enrollment or reenrollment in the health care programs. 
  • Payment: Establish payment methodologies that are reasonable and responsive to changes in the marketplace and medical practice. 
  • Compliance: Assist health care providers and suppliers in adopting practices that promote compliance with program requirements. 
  • Oversight: Vigilantly monitor the programs for evidence of fraud, waste, and abuse. 
  • Response: Respond swiftly to detected fraud, impose sufficient punishment to deter others, and promptly remedy program vulnerabilities. 

When you take the time to understand the goals of the OIG, this will help you build a compliance program that ensures the integrity of government and commercial insurance programs.   

So, let’s take this one step further. 

As a citizen, you want your hard-earned money to be used effectively by the government…right? 

Guess what? 

Each time we don’t actively monitor our compliance program through the correction of errors, our taxpayer dollars are at risk.  

When your practice does its part, that is one more dollar saved, which sustains the future of Federal health care programs.         

 

*The opinions and observations from Joi Sherrod/group are not a promise to exempt your practice from fines and penalties.  Research, modify and tailor the advice to fit your specialty.

**Click here for the next tip in the series.

Joi Sherrod, MPH, CPC, CPCO
Joi Sherrod, MPH, CPC, CPCO
Joi is an educator and owner of JNC Healthcare Compliance Group. After working for distinguished academic teaching hospitals and clinics, she is passionate about helping medical, dental, and behavioral health practices rethink healthcare compliance one trend at a time. Contact Joi at info@jnccompliance.com.