What is a Compliance Program?

A compliance program is a set of internal policies and procedures that helps your organization comply with the law in its daily operations. A proactive plan helps you maintain compliance with today’s regulations, as well as providing a framework for implementing future requirements.

Effective compliance programs share the following common elements: written policies and procedures, effective training, effective communication, internal monitoring and enforcement, and prompt response times. Nevertheless, every compliance program will be unique, based on the specific organization’s operations, structure, and areas of risk.

Every organization is structured differently, has unique staffing and contracting programs, provides a different mix of services, and has a specific profile of patient demographics and payer mix. To help you develop a compliance program that is most impactful for your organization, the OIG has developed a set of principles, called CPGs, geared toward different segments of the healthcare industry.

Use these CPGs as a starting point, and then tailor them for your organization. Also remember that a compliance program is never done – it evolves with your business and with changing regulations. It is forward-looking, and focused not only on risk containment, but also on best care and management practices.

 

Sources:

OIG Voluntary Compliance Program Guidance

OIG Training Video – Compliance Program Basics

OIG Healthcare Compliance Program Tips