While healthcare facilities face a complicated regulatory landscape, having a secure and well-functioning compliance program can help limit risk, according to a Jan. 17 blog post from Coronis Health.
The HHS Office of Inspector General has issued compliance plan guidance for medical practices: one published in 1998 and a supplement published in 2005.
However, ASCs should also have their own internal risk plans, Coronis advises in the blog post. The first part of a compliance plan is to identify risks.
ASCs should have a compliance officer who identifies issues that have a real potential for violating various federal regulations, such as coding, documentation of services, documentation retention and billing.
Risk areas should be identified, documented and disseminated in the form of training for appropriate personnel, and policies should be put in place to minimize identified risks, according to the post.
In 2022, the Justice Department launched new guidelines, known as the Monaco guidelines, that "put more teeth" into the prosecution of noncompliant behavior from U.S. companies, the blog post said.
Now, if an ASC violates OIG compliance guidelines, its CEO, CFO and low-level staff could all be held responsible.
A history of misconduct will also be a component in the assessment of penalties by the Justice Department, and prior wrongdoing by the same individuals or facilities will be deemed of special concern.
The agency will also take into consideration an ASC's track record of response to inappropriate behavior among its personnel. It will be more important for ASCs to ensure that any compliance plan contains significant consequences for employees who engage in noncompliant behavior and that these rules are clearly communicated.