2000 OPEN FORUM Abstracts
"Real World" Compliance: Lessons Learned Two Years Later
Judy A. Dye, MA University Medical Center, Tucson, Arizona
The creation of compliance plans has become a priority among healthcare organizations. As annual healthcare expenditures top one trillion dollars, claims of fraud and abuse against Medicare providers have escalated. Ensuing investigations have resulted in over one billion dollars recovered in civil penalties to date. It is little wonder that institutions are rushing to develop and implement compliance plans.
But what takes place in those ensuing months following the startup of a compliance program? Are policies and procedures adequate to cover all aspects of the program? Is the compliance "hotline" a trusted resource or a necessary evil for the staff? How often, and to what degree, should self-audits be scheduled? What ordering and coding processes need to be altered to ensure regulatory and financial compliance?
This program will present one hospital's experience with a compliance program two years after completion. It will examine actual events, problems, and successes that happened following the plan's start in summer 1998, and serve as an invaluable guide to ensuring the success of your recently implemented program.
You will learn to:
? Identify and implement projects that support two types of compliance--regulatory and financial
? Plan successfully to avoid the problems that can develop once your plan is in place
? Prepare for and respond effectively to an OIG investigation
? Integrate the compliance and code of conduct philosophy into your everyday operations