Anesthesia Compliance for Your Organization

Has your organization considered Anesthesia Compliance & Training to meet the requirements of the Office of Inspector General (OIG)?  Have you recently updated your compliance policies and procedures?  Have you trained your staff on the latest federal regulations that might affect your billing for anesthesia? We have a solution for your anesthesia company.  Let us help with your anesthesia compliance plan and your compliance training.

Having an anesthesia compliance plan is important for many reasons but the most important is that it is mandated by the Affordable Care Act (ACA) and recommended by the Office of Inspector General (OIG). In addition, the United States Sentencing Guidelines lists a compliance plan as one of the factors that will be considered by the Department of Justice (DOJ) during an investigation or determination of prosecution, resolution or form of penalty. A well-designed plan is the best way of preventing billing errors and potential claims of fraud, waste or abuse. It can also help you in the case of a review or audit by a federal or state program and prevent or lessen legal expenses, fines or penalties.

Why Compliance is Important

The Office of Inspector General (OIG) has given clear direction in the publication, Compliance Program Guidance for Individual and Small Group Physician Practices, on establishing a voluntary compliance plan. The intent of this initiative was to assist in preventing submission of erroneous claims or engaging in unlawful conduct involving the federal health care programs. By developing these compliance plans health care providers can use internal controls to better monitor the adherence to applicable statutes, regulations and program requirements.

The Federal Sentencing Guidelines explicitly reward the adoption of an effective compliance program by reducing the imposed sanctions. For years the Office of Inspector General (OIG) has encouraged providers to implement compliance programs. They have also indicated providers who lack programs risk more severe sanctions if penalties are given.

Fighting Fraud

The National Health Care Anti-Fraud Association reports that financial losses due to fraud can be as much as ten billion dollars. The U.S. HHS and OIG recovered $5.9 billion related to healthcare fraud in 2019.

It is important for all healthcare organizations to understand the laws and regulations and comply with them and to follow any associated guidelines. Failing to prepare a compliance plan and compliance training for your organization can result in significant problems in the face of an OIG or DOJ complaint and investigation.

Since 1976, the Department of Health and Human Services Office of inspector General (HHS-OIG) has been working to prevent fraud, waste and abuse in federally funded healthcare programs. These include Medicare, Medicaid and the Children’s Health Insurance Program (CHIP). HHS- OIG’s focus is to protect the integrity of HHS programs as well as the health and welfare of program beneficiaries.

Compliance

An Anesthesia Compliance Plan Is Essential

Initially HHS-OIG published voluntary compliance guidance for individual and small group healthcare practices. Section 6401 of the ACA stipulated that healthcare providers must establish compliance programs as a condition of participation in Medicare, Medicaid and/or the Children’s Health Insurance Program (CHIP). Insurance companies today require or recommend that medical providers develop a compliance program for the protection of the organization.

The Affordable Care Act (ACA) has mandated physicians and group practices to establish compliance programs if they want to provide services under Medicare, Medicaid and Children?s Health Insurance Program.

Commercial insurers are also requiring medical providers to create a compliance plan as a condition of participation in their pro-gram. Those who do not create a plan are at risk of not being allowed to participate in the healthcare program.

CMS insists that medical providers will be able to protect themselves from improper conduct if they create a compliance program. A functional program ensures that government rules are enforced and that they provide quality care. A good compliance program will help prevent criminal behavior, protect against fraud, improper payments, abuse of the system and other liabilities.

ACA Compliance Core Elements

The ACA recommends that healthcare providers implement a compliance plan, if they haven’t yet, that includes the seven core elements as a foundation for their program.

  • Establish and adopt written policies and procedures to promote the provider’s commitment to compliance. Include sanction screenings as part of the healthcare compliance plan. Ensure that there’s a routine process in place to monitor potential compliance issues.
  • Identify and appoint an individual to serve as the compliance officer and charge this person with the responsibility for monitoring compliance efforts and enforcing practicing standards.
  • Establish reporting systems whereby individuals can report complaints about compliance items without fear of retaliation. Some providers have found it to be helpful to set up an anonymous hotline number.
  • Make a commitment to offering formal education and training programs at all levels of employment. Make it part of the employee orientation process.
  • Continually audit and monitor systems to ensure that they are effective and to head off potential problems.
  • Develop policies to enforce the standards of conduct and establish disciplinary measures for employees who don?t comply with the requirements.
  • Take corrective action when vulnerabilities are identified.

HIPAA Privacy Rule

The Privacy Rule established standards for the protection of health information. The US Department of Health and Human Services (HHS) issued the Privacy Rule to implement the requirements of the Health Insurance Portability and Accountability Act (HIPAA). The Privacy Rule establishes standards for individuals’ privacy rights to help them control the use of their health information. One of the goals of the Privacy Rule is to assure proper protection of individuals’ health information while allowing the necessary flow of health information to provide and promote health care and to safeguard health and well-being.  All anesthesia providers must be aware of the HIPAA Privacy Rule.

Anesthesia Compliance Consultants (ACC) have been in the business of HIPAA consulting since the Privacy Rule went into effect. We have assisted many large organizations in developing their HIPAA Privacy programs. Our professionals are prepared to assist you with all these important policies and procedures. ACC develops and consults on HIPAA compliance plans that include HI-PAA privacy and security, policies and procedures and breach reporting requirements in compliance with the HIPAA Rules. Of great importance, ACC is always available to assist you when questions arise regarding the HIPAA Rule. We would be happy to discuss with you how we can help with your program.

Our Services

Anesthesia Compliance Consultants (ACC) will assist your organization with a compliance plan & training that covers the seven compliance core components. Our team of experienced professionals, crafts compliance plans consistent with regulatory, medical, billing and coding standards. Our professionals have been involved in the business of anesthesia compliance since 2002 and have the experience both legal and as anesthesia providers to fully comprehend the needs of anesthesia practices.

How we can help

Anesthesia Compliance Consultants is able to provide your organization the necessary help it needs to create a Compliance plan, HIPAA Privacy Plan and train your staff to meet governmental guidelines for full compliance. Watch our video to learn more about our services.

Compliance Plans

Anesthesia Compliance Consultants will assist with the creation of a compliance plan for your organization. Our team of experienced professionals crafts compliance plans consistent with regulatory, medical, billing and coding standards for anesthesia.

Compliance Template Plans begin at $500

Compliance Plans
Anesthesia Compliance Plans

Anesthesia HIPAA Privacy Plans

ACC will assist with the creation of a HIPAA Privacy compliance plan for your anesthesia organization. Our team of experienced profes-sionals crafts HIPAA privacy plans consistent with all regulatory standards.

Compliance Template Plans begin at $500

HIPAA Privacy Plans
Privacy Plans

Compliance & HIPAA Training

A critical part of any effective compliance program is appropriate training and ed-ucation. A company must ensure that policies and procedures are integrated and made active through initial and periodic training of employees, contractors, and oth-er stakeholders. We are prepared to help train your staff in all important aspects of compliance and privacy to protect your organization from violation of federal guide-lines. We have a variety of courses that are available to meet these needs. We offer several courses in an online setting.

Courses available at $65.00

  • Anesthesia Compliance
  • Anesthesia HIPAA Privacy
  • Anesthesia Compliance and Privacy
Compliance & HIPAA Training
Anesthesia Compliance HIPAA Training

Online Group Training

Anesthesia Compliance Consultants can provide online group training that is thorough and efficient. We will educate your company on anesthesia compliance and HIPAA privacy. We will assist your Privacy Officer to make sure all of your personnel are trained and the results recorded.

Online Group Training

Customized Training

Some organizations may want to create their own customized program with company branding. Allow us to create a program tailored specifically for your organization, type of practice or company. Contact us to discuss your options.

Contact Us for Customized Training

 

“We understand anesthesia: we have stood in your shoes.”