This process can also help a provider in identifying employee training and training needs. While compliance packages were “voluntary” up to now, legislative adjustments now mandate that Medicare and Medicaid providers and suppliers develop and implemen

This process can also help a provider in identifying employee training and training needs. While compliance packages were “voluntary” up to now, legislative adjustments now mandate that Medicare and Medicaid providers and suppliers develop and implement an effective compliance program. The writing is on the wall – compliance is now not voluntary – it is the first place a prosecutor will look in case your well being care organization is accused of fraud. Finally, staff must perceive the consequences of failing to stick to their organization’s insurance policies and procedures. An efficient compliance plan contains procedures for imposing and disciplining employees who violate the provider’s policies. Provisions for enforcement and self-discipline are essential to add credibility and reliability to the compliance program.


For example, in a “paper” program, while staff are doubtless informed to behave ethically, they may lack leadership examples or struggle to complete job tasks in a compliant style. Whether because of elements such as compensation buildings that trigger conflicts of interest or unrealistic productivity expectations coupled with management pressure, such inconsistencies send a decidedly blended message. It is not sufficient to simply undergo the motions; leaders must show in words and action that compliance is essential and necessary. Incorporate updates and instruments from enforcement authorities and other resources into training and compliance initiatives. Embed compliance into operations, and reduce duplication of efforts with an enterprise risk administration method.

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