Question

Discuss how an effective compliance program works with the Anti-Kickback Statute.

Answer 1

Ans) Although the consequences of violating these laws are no small matter, there are many policies, procedures, and practices available to help health care organizations remain compliant with both the Stark Law and the AKS.

- The most overarching way organizations can maintain compliance with these laws is by ensuring their compliance programs are effective and operating as recommended by the Department of Health and Human Services Office of Inspector General (OIG).

- In the OIG’s Compliance Program Guidance documents¹, there are seven key elements of an effective compliance program including:

• Implementing written policies, procedures and standards of conduct.
• Designating a compliance officer and compliance committee.
• Conducting effective training and education.
• Developing effective lines of communication.
• Conducting internal monitoring and auditing.
• Enforcing standards through well-publicized disciplinary guidelines.
• Responding promptly to detected offenses and undertaking corrective action.

- The most notable of these elements as it relates to compliance with the Stark Law and the AKS is implementing written policies, procedures and standards of conduct.

- By following necessary policies and procedures for these laws, health care organizations can avoid instances of improper referrals and other remuneration fraud or abuse. Compliance Resource Center’s Policy Resource Center (PRC) is a beneficial resource for health care organizations that want to make sure they have the right policies and procedures in place to stay compliant with the Stark Law and the AKS. The PRC houses hundreds of customizable policy and procedure templates that cover Stark Law and AKS, along with a variety of other compliance topics. Included under documents and templates for these laws, the PRC has policies for gifts, joint ventures, patients, physician arrangements, physician recruitment, safe harbors, and vendor relationship.