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CodeMap® Maintaining Effective Compliance Programs for Hospital and Independent Labs::Recorded October 25, 2017

Maintaining Effective Compliance Programs For Hospital and Independent Labs

Wednesday, October 25, 2017
2:00 - 3:15 pm (Eastern Time)

Maintaining an effective compliance program requires a significant investment of time, resources, and expertise. The laws, rules, and regulations that govern participation in Medicare and Medicaid are constantly changing. In addition, the focus of enforcement agencies, such as the OIG and Department of Justice, evolve over time so that practices that were compliant years ago, may now expose your laboratory to significant liability.

Now is the time to ensure your organization continues to operate an effective compliance program. The following critical components of compliance programs will be discussed:

  • Employee and Customer Screening: All laboratories must implement and maintain procedures to ensure that no employees or contractors are excluded. In addition, recently increased civil monetary penalties demand laboratories also screen referring customers. We will discuss best practices based upon recent OIG guidance, recent settlement agreements, and Corporate Integrity Agreements (CIAs). 
  • Policy Development: The OIG published the original compliance guidance for laboratories almost 20 years ago. Since that time laboratory technology, practices, and associated rules and regulations have changed significantly. You need to know which policies are essential today, which policies must be updated, and which policies are no longer necessary. We will also discuss how to maintain current and effective policies. 
  • Compliance Training: No compliance program will be effective without robust and ongoing compliance training for employees. All laboratories know this, however, many struggle with questions concerning which employees should be trained, what content should be covered, and how often should laboratories provide training. We will explore these questions, as well as how to develop refresher courses so that employees are not forced to sit through the same training year after year. 
  • Hospital Programs vs. Laboratory Programs: Many hospital laboratories must adhere to umbrella programs that cover all departments of the medical center. These programs are typically administered by the Office of Compliance or Office of General Counsel. Such programs are often effective, however, clinical laboratories possess their own unique compliance issues. We will discuss how hospital programs must also serve these needs, and suggest ways hospital administration can work with laboratories to ensure effective compliance management. 
  • Auditing: Yet another essential component of effective compliance programs is auditing and monitoring. We consult with numerous laboratory programs every year and have assessed many auditing techniques including claims reviews, chargemaster reviews, post-payment monitoring, and of course annual compliance audits. We will discuss which mechanisms work, and which are difficult to effectively perform and maintain. We will also discuss the always important components of documentation and responding to discovered deficiencies and possible liabilities. 

Price: $225.00

Video of Presentation and PDF Handouts.

CodeMap® is a Registered Trademark of Wheaton Partners, LLC.